Hemmorhage Control & Shock Flashcards
What is shock?
Life threatening acute failure associated with inadequate perfusion
What does shock lead to?
Cellular dysfunction & hypoxia
Switches to anaerobic metabolism and is associated with increased lactate levels
How does shock progress?
- Red blood cells decrease
- Inadequate perfusion
- Hypoxia worsens
- Anaerobic processes
- Catecholamine increases
- Cell death
What pattern can you see in compensated shock?
15- 25% blood Volume
Weakness
Pallor
Tachycardia
Narrowed pulse pressure
Thirst
Delayed capillary refill
What patterns can you see in decompensated shock?
30-45% of blood volume
Hypotension
Weak or no peripheral pulse
Prolonged capillary refill
What is the first sign of late shock?
Hypotension
What are the 4 types of shock?
Hypovolemic
Distributive or high space shock
Obstructive shock
Cardiogenic shock
signs of early hypovolemic shock?
Weakness
Pallor
Tachycardia
Tachypnea
Diaphoretic
Thirst
Low urinary output
Weak Peripheral pulses
Signs of late hypovolemic shock?
Hypotension
Altered LOC
Cardiac arrest
At what sustained heart rate should you suspect hemorrhage?
> 100
What pulse rate is a red flag for shock?
> 120
What causes vasoconstriction during blood loss?
Catecholamines
Minor blood loss
Vasoconstriction is sufficient
Severe blood loss
Vasoconstriction insufficient
What is the clinical presentation of low Volume shock?
Thready pulse
Tachycardia
Pale
Flat neck veins
What is relative hypovolemia ( form of high space shock)?
Interruption of sympathetic system
Loss of normal. Vasoconstriction
Vascular space becomes too large
When does neurogenic shock occur?
Typically after injury to the spinal cord
No release of catecholamines from adrenals
What are symptoms of neurogenic shock?
-hypotension
-normal or slow heart rate
-skin appears PWD
-paralysis or deficit
-diaphragmatic breathing
What is mechanical shock
Blood flow obstruction to or though the heart
-slow venous return
-decrease in cardiac output
What are clinical signs of mechanical sock?
Distended neck veins
Cyanosis
Ctecholamine effects
- pallor, tachycardia, diaphoretic
What is cardiogenic shock?
Reduced pumping strength in pat of the heart
-decrease in cardiac output
Decrease in blood pressure
What are 2 causes of cardiogenic shock?
Cardiac contusion
Myocardial infarction
What GCS would a patient with a severe head injury experiencing hypovolemic shock?
8 or less
What are the basic rules of shock management? (CABC)
C-control bleeding where possible
A-maintain airway
B-maintain oxygenation and ventilation
C-maintain circulation
