Chapter 8 - Shock Flashcards
Most common cause of death is insufficient _____
EARLY resuscitation
What is the fick principle (3 steps)
- On-loading of O2 to RBC in the lung
- Delivery of RBC to tissue cells
- Off-loading of O2 from RBC to tissue cells
Organ tolerance to ischemia - heart /brain/lung
4-6min
Organ tolerance to ischemia - kidney/liver/GI tract
45-90 min
Organ tolerance to ischemia - muscle/bone/skin
4-6h
4 types of shock
Hypovolemic shock
Distributive shock
Obstructive shock
Cardiogenic shock
Characteristic of distributive shock
Vascular container enlarges without proportional increase in fluid volume
Can occur when a C/S injury damages the spinal cord above where the nerves of the sympathetic nervous system exit
Neurogenic - distributive shock
What is a septic shock?
Exhibits vascular dilation
Obstructive shock vs cardiogenic shock
obstructive is extrinsic of the heart
cardiogenic is intrinsic - intracardiac cause of cardiac pump failure
name the 3 stages of shock
Pre-shock
Shock
End-organ dysfunction
What is pre-shock
body’s compensatory mechanism are able to maintain some degree of tissue perfusion
What is shock (decompensated)
body’s compensatory mechanisms fail to maintain tissue perfusion (BP falls)
What is end-organ dysfunction
tissue and cellular damage is so massive that the organism dies even if perfusion is restored
Is the 3rd stage of shock reversible?
IRREVERSIBLE - end-organ dysfunction
Pulse
Skin
BP range
LOC
during compensated shock
increased, tachy
white, cool, moist
normal
unaltered
Pulse
Skin
BP range
LOC
during decompensated shock
marked increased/tachy/can progress to brady
white cold waxy
decreased
altered from disoriented to coma
First symptoms you would expect in shock recognition? (2)
increase respiratory rate
increase HR
Second most common physiological response to the development of shock?
Peripheral vasoconstriction
What is the type of shock where skin temp is warm/dry
skin color is pink
Bp drops
LOC lucid
Cap refill normal
Neurogenic shock
Pre-hospital management of shock should focus on what
DELIVER ADEQUATE O2
Trauma patients in shock should be transported ____ and ____ unless indicated otherwise
supine & neutral
