Chapter 15 - Shock and Resuscitation

Question 1

anaphylactic shock

Answer 1

a shock (hypoperfusion) state that results from dilated and leaking blood vessels related to severe allergic reaction. Also called anaphylaxis or anaphylactic reaction.

Question 2

asystole

Answer 2

a heart rhythm indicating absence of any electrical activity in the heart. Also known as flatline.

Question 3

automated external defibrillator (AED)

Answer 3

a device that can analyze the electrical activity or rhythm of a patients heart and deliver an electrical an electrical shock (defibrillation) if appropriate.

Question 4

burn shock

Answer 4

a form of nonhemorrhagic hypovolemic shock resulting from a burn injury.

Question 5

cardiac arrest

Answer 5

the cessation of cardiac function with the patient displaying no pulse, no breathing, and unresponsiveness.

Question 6

cardiogenic shock

Answer 6

poor perfusion resulting from an ineffective pump function of the heart, typically the left vintricle.

Question 7

chain of survival

Answer 7

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.

Question 8

compensatory shock

Answer 8

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.

Question 9

defibrillation

Answer 9

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.

Question 10

distributive shock

Answer 10

shock associated with a decrease in intravascular volume caused by massive systemic vasodilation and an increase in the capillary permeability.

Question 11

downtime

Answer 11

the time from when the patient goes into cardiac arrest until CPR is effectively being performed.

Question 12

hemorrhagic hypovolemic shock

Answer 12

shock from the loss of whole blood from the intravascular space. Often just called hemorrhagic shock.

Question 13

hypoperfusion

Answer 13

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.

Question 14

hypovolemic shock

Answer 14

shock caused by the loss of blood or fluid from the intravascular space resulting in a low blood volume.

Question 15

irreversible shock

Answer 15

the stage of shock in which interventions are unable to prevent the advance of shock to death.

Question 16

nonhemorrhagic hypovolemic shock

Answer 16

shock caused by loss of fluid from the intravascular space with red blood cells and hemoglobin remaining within the vessels.

Question 17

obstructive shock

Answer 17

a poor perfusion state resulting from a condition that obstructs forward blood flow.

Question 18

pulseless electrical activity (PEA)

Answer 18

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.

Question 19

resuscitation

Answer 19

bringing a patient back from potential or apparent death; an attempt to restore normal or adequate physiologic function.

Question 20

return of spontaneous circulation (ROSC)

Answer 20

return of a spontaneous pulse during the cardiac resuscitation.

Question 21

septic shock

Answer 21

a type of distributive shock caused by an infection that releases bacteria or toxins into the blood.

Question 22

shock

Answer 22

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.

Question 23

sudden death

Answer 23

death of a patient within 1 hour of the onset of signs and symptoms.

Question 24

survival

Answer 24

term applied to a patient who survives cardiac arrest to be discharged from the hopital.

Question 25

total downtime

Answer 25

the total time from when a patient goes into cardiac arrest until his is delivered to the emergency department.

Question 26

unwitnessed cardiac arrest

Answer 26

a cardiac arrest, with the patient already unresponsive, apneic, and pusleless, when EMS arrives on the scene.

Question 27

ventricular fibrillation (VF or V-Fib)

Answer 27

a continuous, uncoordinated, chaotic rhythm that does not produce pulses.

Question 28

ventricular tachycardia (VT or V-Tach)

Answer 28

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.

Question 29

witnessed cardiac arrest

Answer 29

a cardiac arrest in which an EMT or other emergency responder witnesses the patient become unresponsive, apneic, and pulseless.

Question 30

What is needed to maintain adequate cell perfusion?

Answer 30

1. Patient must be breathing adequate amount of oxygen with each breath.
2. Oxygen in the alveoli must be able to effectively diffuse across the alveolar/capillary membrane and enter the blood.
3. Once diffused into the blood, oxygen must bind to hemoglobin as its primary carrying vehicle.
4. Once it reaches the tissue level, oxygen must release from hemoglobin and diffuse across the capillary and into the cell.

Question 31

Three etiologies of shock.

Answer 31

1. inadequate volume
2. inadequate pump function
3. inadequate vessel tone

Question 32

inadequate volume

Answer 32

typically due to decreased blood or fluid volume

Question 33

inadequate pump function

Answer 33

typically due to failure of the pump - the heart

Question 34

inadequate vessel tone

Answer 34

typically due to a change, or decrease in peripheral vascular resistance (PVR).

Question 35

What are the three stages of shock?

Answer 35

compensatory
decompensatory
irreversible

Question 36

neural response to shock

Answer 36

sympathetic nervous system