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Y4R6 - Pediatrics II 👶 > L4: Shock > Flashcards

L4: Shock Flashcards

1
Q

Def of Shock

A
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2
Q

Pathophysiology of Shock

A
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3
Q

Compensatory Mechanisms in Shock

A
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4
Q

Stages of Shock

A
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5
Q

Stages of Shock

  • BP
  • Blood Flow
  • Vital Organs Function
A
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6
Q

CP of Shock

A
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7
Q

CP of Shock

  • Vital Organs
A
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8
Q

CP of Shock

  • Pulse
A
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9
Q

CP of Shock

  • RR
A
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10
Q

CP of Shock

  • BP
A
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11
Q

CP of Shock

  • Skin
A
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12
Q

CP of Shock

  • CRT
A
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13
Q

CP of Shock

  • Level of Consciousness
A
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14
Q
  • Early diagnosis requires a high index of suspicion.
  • Diagnosis is made through the physical examination focused on tissue perfusion.
  • Hypotension is a late & pre-morbid sign.
A

…

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15
Q

Early Signs of Shock

A
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16
Q

Late signs of shock

A
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17
Q

Initial evaluation of shock

A
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18
Q

Classification of Shock

A
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19
Q

Incidence of Hypovolemic Shock

A
  • Most common form of shock world-wide
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20
Q

Etiology of Hypovolemic Shock

A
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21
Q

CP of Hypovolemic Shock

A
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22
Q

TTT of Hypovolemic Shock

A
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23
Q

Septic Shock

A
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24
Q

Charaters of Warm Septic Shock

A

◈ Early
◈ Compensated
◈ Hyperdynamic state

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25
Q

Warm Septic Shock

  • Clinical Signs
A
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26
Q

Warm Septic Shock

  • Physiological
A
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27
Q

Warm Septic Shock

  • INVx
A
  • Hypocarbia – elevated lactate
  • Hyperglycemia
28
Q

Warm Septic Shock

  • TTT
29
Q

Cold Septic Shock

30
Q

Cold Septic Shock

  • Charcaters
A

◈ Late
◈ Uncompensated
◈ Drop in cardiac output

31
Q

Cold Septic Shock

  • Clinical Signs
32
Q

Cold Septic Shock

  • Physiological
33
Q

Cold Septic Shock

  • INVx
A
  • Hypoxia – metabolic acidosis
  • Hypoglycemia
  • Coagulopathy
34
Q

Cold Septic Shock

  • TTT
35
Q

Etiology of Cardiogenic Shock

36
Q

CP of Cardiogenic Shock

37
Q

TTT of Cardiogenic Shock

38
Q

Mechanism of Distributive shock

39
Q

Etiology of Distributive shock

A

◈ Anaphylaxis
◈ Early sepsis “warm shock”
◈ Drugs
◈ Neurogenic injury

40
Q

Signs of Distributive shock

A

⇡⇡ COP & ⇣⇣ SVR

41
Q

TTT of Distributive shock

A

◈ TTT of the cause
◈ ABC & fluid
◈ Inotropic: to ⇡⇡ SVR

42
Q

Mechanism of Obstructive Shock

A

Mechanical obstruction to ventricular outflow

43
Q

Etiology of Obstructive Shock

A

◈ Aortic stenosis
◈ Aortic coarctation
◈ Cardiac tamponade
◈ Tension pneumothorax
◈ Hypoplastic left heart syndrome

44
Q

Signs of Obstructive Shock

A

⇣⇣ COP & ⇡⇡ SVR

45
Q

TTT of Obstructive Shock

A

◈ TTT of the cause
◈ Pericardial drain
◈ Chest tube
◈ Surgical intervention
◈ If neonate with ductal dependent lesion ⇢ Prostaglandin E (PGE)

46
Q

Management of Shock

  • Goals
47
Q

Management of Shock

  • Lines
48
Q

Each additional hour of persistent shock was associated with

  • > 2 folds increased probability of mortality
49
Q

Management of Shock

  • Airway and Breathing
50
Q

Management of Shock

  • Indications of ETT
51
Q

Management of Shock

  • Circulation
52
Q

Management of Shock

  • Cardiotonics
53
Q

Management of Shock

  • Indicatiosn of Cardiotonics
A

① Possible cardiogenic or obstructive shock
② Distributive shock
③ Failure to respond to proper volume expansion

54
Q

Management of Shock

  • Examples of Cardiotonics
A

◈ Dopamine ◈ Dobutamine
◈ Epinephrine ◈ Nor-epinephrine
◈ Milrinone ◈ Phenylephrine

55
Q

Management of Shock

  • Route of Cardiotonics
A

All cardiotonic drugs need to be administered through a central line.

56
Q

Management of Shock

  • Doses of Cardiotonics
57
Q

Management of Shock

  • Supportive Therapy
58
Q

Therapeutic end points of resuscitation of shock

59
Q

Signs of multiple organ failure

60
Q

Signs of multiple organ failure

  • CVS
61
Q

Signs of multiple organ failure

  • RESP
62
Q

Signs of multiple organ failure

  • CNS
63
Q

Signs of multiple organ failure

  • Heme
64
Q

Signs of multiple organ failure

  • Renal
65
Q

Signs of multiple organ failure

  • Liver

Y4R6 - Pediatrics II 👶 (32 decks)

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