Clinical shock and deterioration Flashcards
How many stages of shock are there and what are they called?
4 stages, Initial, Compensatory, Progressive, Refactory.
Define the initial stage of shock
Cardiac output is decreased and tissue perfusion is threatened
Define the compensatory stage of shock
Almost immediently, the compensatory stage beings as the body homeostatic mechanisms attempt to maintain co, blood pressure, and tissue perfusion.
Define the progressive stage of shock
The compensatory mechanisms begin failing to meet tissue metabolic needs, and the shock cycle is perpetuated
Define the refectory stage of shock
Shock become unresponsive to therapy and is considered irreversible
What are the main vital sign observations of somebody in shock?
Increased Hr and RR
Decreased SP02 and BP , temperature, Levels of consciousness
What is the general treatment of shock?
Optimise oxygen delivery, Reduce oxygen consumption
(WOB, Pain, keep pt normothermic, decreased oxygen demands)
What are the classifications of shock?
Hypovolemic shock, Distributive shock, cariogenic shock, Obstructive shock
Define Hypovolemic Shock
Occurs when the body loses too much fluid through bleeding, vomiting, diarrhoea, burns, polyuria. Can be referred to as hemorrhagic or non-haemorrhagic depending on type of fluid loss.
Define Distributive shock
Occurs when the body is too big motor or less. The main things is septic shock or anaphylaxis. Main issue is decreased peripheral vascular resistance
Define Cardiogenic shock
Occurs when the heart has failed, this can be due to a massive MI or valve problem or arrhythmias or cardiopathy.
Define Obstructive shock
Occurs due when a mechanical barrier such as cardiac tamponade a pulmonary embolism , tumours or tension pneumothorax. Basically anything that obstructs the circulating volume of blood can be a precursor to hypo fusion
What is the main aim in a patient with shock?
Re-establish perfusion to the vital organs , want the patient to return to homeostatic levels.
What is an inotrope?
Inotropes increase the contractility of the heart.
What are some major vasopressors?
Phenyleophrine, norepinephrine, epinephrine, vasopressin
