Hemorrhaging Shock Flashcards
What is shock?
Inadequate organ perfusion and delivery of nutrient necessary for normal tissue and cellular function. Initially it may be reversible but life-threatening if not treated properly
What are the general features of shock?
(Many due to compensatory responses)
- Cold, sweaty, clammy skin (due to increase sympathetic) **
- Rapid and weak pulse: tachycardia and a small SV
- Rapid and shallow respiration’s
- Often altered consciousness (drowsiness), confusion, irritability, weakness and collapse
What are the physical features of shock?
Blood pressure:
Systolic< 90 mmHg
Diastolic <60 mmHg
- decreased pulse pressure: although (MAP may be normal)
- decreased urine output: (Oliguria < 30 ml/hr)
What is the basis which shock is classified?
Low stroke volume (decreased CO) vs vasodilation (decreased TPR)
How is hypovolemic shock treated?
IV fluids
How is cardiogenic shock treated?
Inotropes, diuresis
How are obstructive shocks treated?
Relieve obstruction
How are septic, anaphylactic and neurogenic shocks treated?
IV fluids, pressors
What forms of shock are measured with low stroke volume?
Hypovolemic
Cardiogenic
Obstructive
Which shocks are measured by vasodilation/distributive?
Septic
Anaphylactic
Neurogenic
What causes septic shock?
Endotoxins
What causes anaphylactic shock?
Allergic reaction
What causes neurogenic shock?
Disruption of the case motor control, loss of sympathetic
What causes obstructive shock?
Obstruction to blood flow- major pulmonary embolism
Mechanical obstruction-cardiac tamponade, tension pneumothorax
What causes cardiogenic shock?
Pump failure- MI, arrythmias
What causes hypovolemic shock?
Reduced blood volume-hemorrhage, burns, pancreatitis (3rd spacing)
How is preload in the measured in thr right atrium?
RAP/CVP
How is pump function measured?
Cardiac output/index
How is afterload measured for shock?
SVR/TPR
How is tissue perfusion measured in shock?
MvO2
What are the characteristics of hypovolemic shock?
decreased preload (R)/RAP/CVP)
Very decreased preload (L) (PCWP/LVEDP)
Decreased cardiac output/index
Increased afterload (SVR/TPR)
Decreased tissue perfusion
What are the characteristics of cardiogenic shock?
Increased preload(R)(RAP/CVP)
Increased preload(L)(PCWP/LVEDP)
Decreased pump function (cardiac output/index)
Increased afterload(SVR/TOR)
Decreased tissue perfusion (MvO2)
What are the characteristics of obstruction due to obstruction of blood flow?
Increased preload(R)(RAP/CVP)
Decreased preload (L) (PCWP/LVEDP)
Decreased pump function
Increased afterload (SVR/TPR)
Decreased tissue perfusion
What are the characteristics of mechanical obstruction shock?
Increased preload (R) (RAP/CVP)
Increased preload (L)(PCWP/LVEDP)
Decreased pump function
Increased afterload
Decreased tissue. Perfusion
