Circulation and Shock Flashcards
What is shock and the two types of it?
So little blood to supply oxygen and nutrients.
Hemmoragic shock - volume loss through bleeding.
Non Hemmoragic shock - Other causes.
What are the causes / types of Non-Haemorrhagic shock?
Cardiogenic: where the heart is failing or fails to generate adequate cardiac output e.g. cardiac arrest
Tension pneumothorax: where a build up of pressure in the pleural cavity results in pressure on the superior and inferior vena cava, restricting the return of venous blood to the heart. This results in poor cardiac output and if not relieved will lead to PEA cardiac arrest
Neurogenic: when there is damage to the high thoracic spinal cord with loss of the sympathetic supply to the peripheries resulting in vasodilatation. This causes the circulating volume to be redistributed to the peripheries,significantly reducing venous return to the heart.
Septic: an overwhelming inflammatory response to infection results in peripheral vasodilatation, fluid redistribution and reduced central circulation.
Anaphylactic: an overwhelming inflammatory response to an allergen resulting in peripheral vasodilatation and capillary membranes becoming leaky, leading to tissue oedema and a significant reduction in central circulation
When looking for shock, what are you looking for?
Colour
Respiratory rate,
heart rate,
blood pressure
conscious level.
Normal circulatory volume ?
7% of ideal body weight ~ 70mls per kg
What are the four classes of shock, and how does it change through each class ?
Class 1 - 750ml blood loss or 15%. normal Heart and breathing rate. blood pressure normal, slightly anxious.
Class 2 - 750-1500ml blood loss (15-30%). HR above 100, breathing 20-30 breaths/min. Blood pressure normal, Mildly anxious.
Class 3 - 1500 - 2000ml loss (30-40%) HR above 120. Breathing 30-40 per min. Blood pressure low, Anxious, confused
Class 4 - abov 2000ml loss (40%) HR above 140. Breathing above 35 per min. Bllod pressure low. Confused, lethargic
With Liver/Hepatic/ injury, how does this present and causes ?
Pain in upper right abdomen, right shoulder.
Causes by direct contact trauma, or lower rib fracture.
Spleen/Splenic injury, presentation and cause?
Pain in left upper quadrant of the abdomen and left shoulder.
Blood irritating the diaphragm or due to diaphragmatic rupture.
Rib fracture or blunt trauma.
Kidney/Renal trauma - presentation and causes.
Abdomen may be found to be soft and tender.
Contact trauma
With a long bone fracture, how muhc blood can be hemmoraged from this and what should you do?
1.5litres, so a signcinfcat class2/3 shock response.
Splint the leg, contine to check atheltes radial and carotid pulse.
