Chapter 15 - Shock and Resuscitation Flashcards
anaphylactic shock
a shock (hypoperfusion) state that results from dilated and leaking blood vessels related to severe allergic reaction. Also called anaphylaxis or anaphylactic reaction.
asystole
a heart rhythm indicating absence of any electrical activity in the heart. Also known as flatline.
automated external defibrillator (AED)
a device that can analyze the electrical activity or rhythm of a patients heart and deliver an electrical an electrical shock (defibrillation) if appropriate.
burn shock
a form of nonhemorrhagic hypovolemic shock resulting from a burn injury.
cardiac arrest
the cessation of cardiac function with the patient displaying no pulse, no breathing, and unresponsiveness.
cardiogenic shock
poor perfusion resulting from an ineffective pump function of the heart, typically the left vintricle.
chain of survival
adult: immediate recognition and activation, early CPR, rapid defibrillation, effective advanced life support, integrated post cardiac arrest care.
pediatric: prevention of arrest, early high quality CPR, rapid activation of EMS, effective advanced life support, rapid transport, integrated post cardiac arrest care.
compensatory shock
the stage of shock in which a cascade of organ and gland stimulation and hormones occurs to increase the blood pressure, restore arterial wall tension, and maintain a near normal blood pressure and perfusion of the vital organs. Also called compensated shock.
defibrillation
electrical shock or current delivered to the heart through the patients chest wall or internally from an implanted device to help the heart restore a normal rhythm.
distributive shock
shock associated with a decrease in intravascular volume caused by massive systemic vasodilation and an increase in the capillary permeability.
downtime
the time from when the patient goes into cardiac arrest until CPR is effectively being performed.
hemorrhagic hypovolemic shock
shock from the loss of whole blood from the intravascular space. Often just called hemorrhagic shock.
hypoperfusion
the insufficient delivery of oxygen and other nutrients to some of the body’s cells and inadequate elimination of carbon dioxide and other wastes that results from inadequate circulation of blood. Also called shock.
hypovolemic shock
shock caused by the loss of blood or fluid from the intravascular space resulting in a low blood volume.
irreversible shock
the stage of shock in which interventions are unable to prevent the advance of shock to death.
nonhemorrhagic hypovolemic shock
shock caused by loss of fluid from the intravascular space with red blood cells and hemoglobin remaining within the vessels.
obstructive shock
a poor perfusion state resulting from a condition that obstructs forward blood flow.
pulseless electrical activity (PEA)
a condition in which the heart generates relatively normal electrical rhythms but fails to perfuse the body adequately because of a decreased or absent cardiac output from cardiac muscle failure or blood loss.
resuscitation
bringing a patient back from potential or apparent death; an attempt to restore normal or adequate physiologic function.
return of spontaneous circulation (ROSC)
return of a spontaneous pulse during the cardiac resuscitation.
septic shock
a type of distributive shock caused by an infection that releases bacteria or toxins into the blood.
shock
the insufficient delivery of oxygen and other nutrients to some of the body’s cells and inadequate elimination of carbon dioxide and other wastes that results from inadequate circulation of blood. Also called hypoperfusion.
sudden death
death of a patient within 1 hour of the onset of signs and symptoms.
survival
term applied to a patient who survives cardiac arrest to be discharged from the hopital.
total downtime
the total time from when a patient goes into cardiac arrest until his is delivered to the emergency department.
unwitnessed cardiac arrest
a cardiac arrest, with the patient already unresponsive, apneic, and pusleless, when EMS arrives on the scene.
ventricular fibrillation (VF or V-Fib)
a continuous, uncoordinated, chaotic rhythm that does not produce pulses.
ventricular tachycardia (VT or V-Tach)
a very rapid heart rhythm that may or may not produce a pulse and is generally too fast to adequately perfuse the body’s organs.
witnessed cardiac arrest
a cardiac arrest in which an EMT or other emergency responder witnesses the patient become unresponsive, apneic, and pulseless.
What is needed to maintain adequate cell perfusion?
- Patient must be breathing adequate amount of oxygen with each breath.
- Oxygen in the alveoli must be able to effectively diffuse across the alveolar/capillary membrane and enter the blood.
- Once diffused into the blood, oxygen must bind to hemoglobin as its primary carrying vehicle.
- Once it reaches the tissue level, oxygen must release from hemoglobin and diffuse across the capillary and into the cell.
Three etiologies of shock.
- inadequate volume
- inadequate pump function
- inadequate vessel tone
inadequate volume
typically due to decreased blood or fluid volume
inadequate pump function
typically due to failure of the pump - the heart
inadequate vessel tone
typically due to a change, or decrease in peripheral vascular resistance (PVR).
What are the three stages of shock?
compensatory
decompensatory
irreversible
neural response to shock
sympathetic nervous system
