Circulatory

Question 1

What is shock?

Answer 1

a state of cellular and tissue hypoxia resulting from reduced O2 delivery, increased O2 consumption and or inadequate O2 use.

Question 2

What types of shock are there?

Answer 2

1. Hypovolemic
2. Cardiogenic
3. Distributive
4. Obstructive

Question 3

When is needle thoracentesis indicated?

Answer 3

When there is tension pneumothorax with deteriorating vital signs that include decreased CO, profound shock, or cardiac arrest.

Blunt cardiac arrest warrants a bilateral decompression

Question 4

What is the preferred spot for needle thoracentesis?

Answer 4

5th intercostal mid-axillary line

Question 5

What medication is useful in all shock states?

Answer 5

epi

Question 6

What is the essential treatment of hemorrhaging pt.’s?

Answer 6

-Controlling of the bleed
-Direct pressure will stop most bleeds
-Recognition of occult bleeding is paramount
-initial rapid conveyance to hospital

Question 7

What is class 1 hemmorrhage?

Answer 7

up to 15% blood loss

Question 8

What is class 2 hemmorrhage?

Answer 8

between 15-30% blood loss

Question 9

What is class 3 hemmorrhage?

Answer 9

between 30-40% blood loss

Question 10

What is class 4 hemmorrhage?

Answer 10

greater than 40% blood loss

Question 11

At what stage is significant blood pressure drop seen in the classes of hemmorrhage?

Answer 11

Class 3, which is 30-40% blood loss, decompensating shock.

Question 12

What medication can be used on a bleeding emergency?

Answer 12

TXA

Question 13

What routes can you cannulate a pt.?

Answer 13

-IV
-IO
-External jugular

Question 14

What etiologies cause hypovolemic shock?

Answer 14

-postpartum hemmorhage
-upper GI bleeding
-blunt/penetrating trauma
-ruptured aneurysm or hematoma
-arteriovenous fistula issue

-vomiting/ diarrhea
-increased insensible fluid loss such as burns
-third space fluid loss (pancreatitis/ bowel obstruction)
-renal fluid loss (drug induced diuresis or diabetes insipidus.)

Question 15

What etiologies cause Cardiogenic shock?

Answer 15

-MI
-Arrhythmias
-heart failure
-cardiomyopathy
-myocarditis
-VSD
-valve defects
-blunt cardiac trauma
-beta blockers, Calcium channel blockers

Question 16

What etiologies cause Distributive shock?

Answer 16

-sepsis
-anaphylaxis
-spinal cord injury
-TBI
- cerebral hemorrhage
-addison’s disease

Question 17

What etiologies cause Obstructive shock?

Answer 17

-decreased diastolic filling
-cardiac tamponade
-constrictive pericarditis
-restrictive cardiomyopathy
-decreased venous return
-tension pneumo
-intrathoracic tumor
-increased ventricular afterload
-massive PE
-aortic dissection
-aortic stenosis
-Large systemic emboli
-severe pulmonary hypertension