EM Shock (incomplete) Flashcards
What is the equation for cardiac output
HR x SV
what is stroke volume determined by
preload, contractility and afterload
what is the equation for BP
CO x systemic vascular resistance (SVR)
what is SVR determined by
determined by blood viscosity, vascular tone and vessel length
What is the equation for shock index
HR / SBP
Normal 0.5-0.7, if >1 = decreased LV function
what occurs if shock is not treated
irreversible ischemic damage
- compensatory mechanisms are not able to keep up
- multiorgan failure
What is inotropy
speed and contractibility of the myocardium
autonomic input
increase will imporve the functionality at higher HR
what is chronotropy
heart rate
what is lusitropy
relaxation that allow for cardiac filling
What is the definition of shock
imbalance of O2 supply and O2 demand
What are distributive shocks
a Shift:
septic, anaphylaxis, neurogenic shock
what are the types of shock
distributive
obstructive
cardiogenic
hypovolemic
what occurs duirng distributive shock
intravascular volume is low d/t systemic vasodilation
will have decreased preload, increased SVR
high mortality with septic shock
what is a rapid onset of severe inappropriate reaction from the immune system to exposure
anaphylaxis
What is the immediate anaphylaxis management
epinepherine IM
what is the minimum length of hospital stay after epi administration
4 hours
What are second line medication management for anaphylaxis
steroids: methylpred
antihistamine: benadryl
H22 blocker: ranititine
inhaled bronchodilator: albuterol neb
What is the goal MAP for septic shock
65
What is SIRS
Systmic inflammatory response syndrome
- inappropriate response to stressor
what is the treatment of cardiogenic shock
can give small bolus but watch carefully
maintain MAP to perfuse brain and heart
vasopressors to increase MAP
what occurs with hypovolemic shock
body tries to compensate through autonomic response with increase SVR
m/c cause is GI bleed
what occurs with obstructive shock
increased SVR, decrease CO
what is the most common cause of obstructive shock
PE or severe pulmonary HTN
