Emergencies

Question 1

Shock

(definition)

Answer 1

inadequate perfusion of the vital organs

therefore failure of tissue oxygenation

(cardiac output insufficient to meet metabolic requirements of tissues)

Question 2

Types of Shock

Answer 2

• Hypovolaemic
  
  • haemorrhagic
• Septic
• Cardiogenic - blunt injury, tamponade, air embolus, MI
• Anaphylactic
• Neurogenic - spinal injury causes loss of sympathetic tone therefore hypotension and bradycardia
• Addisonian - due to withdrawl from steroids (write up hydrocortisone)

Question 3

Stage 1 Shock

Answer 3

0 - 15% blood loss
750ml

Anxious but typically asymptomatic

Question 4

Stage 2 Shock

Answer 4

15 - 30% blood loss
< 1500ml

Pulse > 100
Resps > 20
Diastolic BP increases (narrow pulse pressure)

Question 5

Stage 3 Shock

Answer 5

30 - 40% blood loss
< 2000ml

Pulse > 120
Resps > 30
Systolic BP decreasing
+/- confusion

Question 6

Stage 4 Shock

Answer 6

>40% blood loss
>2l

Pulse > 140, weak, thready
Resps > 35
Low systolic, unreadable diastolic
Decreased GCS
Pale, cold, clammy

Question 7

GCS

E1

Answer 7

not opening eyes

Question 8

GCS

E2

Answer 8

eyes open to pain

Question 9

GCS

E3

Answer 9

Eyes open to speech

Question 10

GCS

E4

Answer 10

Eyes open spontaneously

Question 11

GCS

V1

Answer 11

No verbal response

Question 12

GCS

V2

Answer 12

Incomprehensible sounds

Question 13

GCS

V3

Answer 13

Inappropriate words without conversational exchange

Question 14

GCS

V4

Answer 14

Confused/disoriented speech

Question 15

GCS

V5

Answer 15

Coherent speech

Question 16

GCS

M1

Answer 16

No motor response

Question 17

GCS

M2

Answer 17

Abnormal extension to pain

= decerebrate

Question 18

GCS

M3

Answer 18

Abnormal flexion to pain

= decorticate

Question 19

GCS

M4

Answer 19

Withdraws from pain

Question 20

GCS

M5

Answer 20

Localises to pain

Question 21

GCS

M6

Answer 21

Obeys commands