Critical Care/Shock

Question 1

What are the 3 major types of shock

Answer 1

1. Hypovolemic
2. Cardiogenic
3. Distributive

Question 2

Of the vital organs, which is the first “casualty” of hypovolemic shock?

Answer 2

Kidneys (so, monitor creatinine and BUN)

Question 3

Early signs of hypovolemic shock?

Answer 3

• orthostatic hypotension
• tachycardia
• cool skin

Question 4

Distributive shock: examples

Answer 4

• septic shock
• neurogenic shock
• anaphylactic shock

Question 5

SIRS (systemic inflammatory response syndrome) criteria

Answer 5

need 2 of the following:

1. Temperature >38 C or <36 C
2. Pulse >90
3. Respiratory rate >20
4. PaCO2 <32 mmHg
5. WBC >12,000 or <4,000
6. > 10% bands

Question 6

Sepsis

Answer 6

SIRS + known source of infection

Question 7

Severe Sepsis

Answer 7

Sepsis + organ dysfunction (ex. altered mental status, renal failure)

Question 8

What is the significance of the wedge pressure?

Answer 8

reflects the left ventricular pressure

Question 9

What is normal pulmonary capillary wedge pressure?

Answer 9

6-12 mmHg