Chapter 7: Shock

Question 1

A good sign of adequate resuscitation is

Answer 1

A warm, dry, pink toe

Question 2

One of the first visible signs of shock

Answer 2

Altered level of consciousness

Question 3

5 conditions that can produce an altered level of consciousness or change in behavior

Answer 3

1. Hypoxia (easiest to treat)
2. Shock with impaired cerebral perfusion
3. TBI
4. Drug or alcohol intoxication
5. Diabetes, seizures and eclampsia

Question 4

One of the earliest signs of shock

Answer 4

Tachypnea

Question 5

A single femoral fracture may be associated with up to ___ of blood loss into a thigh

Answer 5

2-4 units

1000-2000 ml

Question 6

Patients in need of immediate management of their airway in order of importance

Answer 6

1. Patients who are not breathing
2. Patients with obvious airway compromise
3. Patients who have respiratory rates in excess of 20 breaths a minute
4. Patient who has noisy sounds of ventilation

Question 7

4 situations when the PASG may benefit the patient in shock from blood loss

Answer 7

1. Pelvic fracture with hypotension SBP <60
2. Profound hypotension SBP <50-60
3. Intraperitoneal hemorrhage with hypotension
4. Retroperitoneal hemorrhage with hypotension

Question 8

Contraindications of the PASG

Answer 8

1. Penetrating thoracic trauma
2. Splinting of lower extremity fracture
3. Evisceration of abdominal organs
4. Impaled objects in the abdomen
5. Pregnancy
6. Trauma red

Question 9

IVF administration is only beneficial when three conditions exist

Answer 9

1. The patient is bleeding at a rate of 25 to 100 ml/hour
2. The IV fluid rate is equal to the bleeding rate
3. Scene time and transport exceeds 30 minutes

Question 10

The preferred site for percutaneous access (IV access)

Answer 10

Vein of the forearm

Question 11

Fluid of choice for the resuscitation of a patient in severe hemorrhagic shock

Answer 11

Blood

Question 12

The isotonic crystalloid solution of choice for the management of shock is

Answer 12

LR

Question 13

LR contains electrolytes such as

Answer 13

Sodium
Potassium 
Calcium
Chloride 
Lactate ions

Question 14

IV fluids should be warmed to about

Answer 14

102 degrees

Question 15

Synthetic colloid solutions

Answer 15

Albumin (protein)

Question 16

Volume resuscitation for uncontrolled hemorrhage

Answer 16

IV crystalloid solution

Titrate to keep SBP 80 to 90 (MAP 60-65)

Do not bolus

Question 17

Volume resuscitation for TBI

Answer 17

Maintain SBP above 90

MAP 85-90

Question 18

Volume resuscitation for controlled hemorrhage for class 2, 3, or 4 shock

Answer 18

Rapid bolus of 1 to 2 L warmed LR

Peds= 20ml/kg warmed

Question 19

An initial fluid bolus elicits 3 possible responses

Answer 19

1. Rapid response =
   VS WNL; less than 20% of blood lost
2. Transient response=
   VS fluctuate; typically lost 20-40% of blood
3. Minimal or no response=
   No change; profound signs of shock after 1 to 2 L bolus