Class 5 hypovolemic and distributive shock Flashcards
What is flushed a sign of?
Septic shock not an MI
MI refers to myocardial infarction.
What is the most common type of shock seen in practice?
Hypovolemic shock
This is emphasized as important for testing.
Define absolute hypovolemia.
Major fluid loss that can be measured.
Define relative hypovolemia.
Bleeding or fluid loss that cannot be measured, such as internal bleeds or third spacing syndrome.
What are the components of the lethal triad?
- Hypothermia
- Acidosis
- Coagulopathy
What is the general treatment for hypovolemia?
- Stop loss
- Replace loss (e.g., PRBC, IV fluids)
What is the treatment for hemorrhaging hypovolemia?
- Whole blood, consisting of 4 units of RBC, 4 units of plasma, and 1 bag of platelets.
- TXA (Coagulant will help blood clot)
What types of fluids are used for non-hemorrhaging hypovolemia?
- Colloids (e.g., albumin, fresh frozen plasma)
- Crystalloids (e.g., lactated Ringer’s, normal saline)
If someone is fluid overloaded but hypovolemic, what kind of fluid should be used?
Colloids since they remain in the vascular space.
List five assessments to determine if interventions for hypovolemic shock are effective.
- Blood pressure returns to normal
- Heart rate and respiratory rate decrease
- Increased urine output
- Increased skin perfusion
- Return to normal mental status
What are the three types of distributive shock?
- Anaphylactic
- Septic
- Neurogenic
What important tests are needed for shock assessment?
- CBC
- ABG
- COAGS
- Lactate
- Electrolytes
- Blood cultures
Which should be administered first during the treatment of shock: antibiotics or IV fluids
IV fluids since they act more quickly than antibiotics.
What are specific signs and symptoms of septic shock?
- Temperature dysregulation
- Increased WBC
What is the most important treatment for septic shock?
Antibiotics and then IV fluids.
What is the difference between anaphylaxis and anaphylactic shock?
Anaphylactic shock there will be massive vasodilation anaphylaxis there will not be
What are specific signs and symptoms of anaphylactic shock?
- Stridor (high pitched whistiling from narrowed airways)
- Rash
- Swelling
What are general signs and symptoms of hypoperfusion during shock?
- Tachycardia
- Tachypnea/hyperventilation
- Hypotension
- Decreased urine output
- Altered neurological status
- GI dysfunction
What is neurogenic shock?
A spinal cord injury causing interruption of sympathetic tone, leading to massive vasodilation.
What are specific signs and symptoms of neurogenic shock?
- Bradycardia
- Dry warm skin initially, then cold as shock progresses
How would you treat neurogenic shock?
- Atropine (to maintain normal HR)
- Temperature regulation
What is the mechanism of action for atropine?
Atropine blocks the parasympathetic NS, mimicking sympathetic NS actions to increase HR and indirectly increase BP.
What are the general principles of treatment for all types of shock?
- Identify and treat the cause
- Increase O2 supply
- Decrease myocardial O2 demand
What is the lethal triad related to severe blood loss
combination of three conditions that often occur together in patients with severe blood loss, and significantly decrease the chance of survival
What does TXA stand for
tranexamic acid
