Lecture 4/Chapter 13

Question 1

Shock

Answer 1

In a set of actively dying

Question 2

Perfusion

Answer 2

Circulation of blood within an organ/tissue in adequate amount to meet cells needs

Question 3

What does poor perfusion cause?

Answer 3

Cell damage and cell death

Question 4

What exactly causes cellular damage during poor perfusion?

Answer 4

A buildup of CO2

Question 5

What can shock be caused by?

Answer 5

Heart attack, severe allergic reactions, MVAs, blunt or penetrating trauma, severe infections, etc.

Question 6

What are the classic signs of shock caused by?

Answer 6

Increased heart rate, increased force of contraction, peripheral vasoconstriction, increased respiratory rate, and bronchial dilation

Question 7

What do you always do when someone is showing signs of shock?

Answer 7

Give high flow O2, put patient in proper positioning (not always shock position), and cover the patient with a blanket.

Question 8

Compensation

Answer 8

The body’s way of trying to recover from going into shock, i.e., Fight or Flight response

Question 9

Classic Signs of Shock

Answer 9

Agitation, anxiety, restlessness, tachycardia, tachypnea, pale, cool, diaphoretic skin, and dilated pupils

Question 10

What are the 3 stages of shock?

Answer 10

Compensated, decompensated, and irreversible shock

Question 11

Compensated Shock

Answer 11

Body compensates to maintain homeostasis
S/S: Agitation, anxiety, restlessness, weak rapid pulse, 2 second cap refill, pale cool moist skin, tachypnea, N/V, and thirst

Question 12

Decompensated Shock

Answer 12

Body in unable to compensate
S/S: BP drops, deteriorating LOC, labored irregular breathing, ashten mottled cyanotic skin, thready or absent pulse, dull eyes, dilated pupils, and poor urinary output

Question 13

Irreversible Shock

Answer 13

The terminal stage
Transfusion will not help, extreme acidosis, impossible to know when patient reaches this point, and must be treated aggressively

Question 14

When should you expect shock to occur?

Answer 14

After multiple severe fractures, abdominal or chest injuries, spinal injuries, major heart attack, severe allergic reactions, and severe infection

Question 15

Respiratory Insufficiency

Answer 15

Occurs when 3 or more ribs are broken in 2 or more places. Causes paradoxical motion and may cause pulmonary contusion, hemorrhage, and pneumothorax

Question 16

What are the 4 categories of shock?

Answer 16

Hypovolemic, Cardiogenic, Obstructive, and Distributive Shock

Question 17

Hypovolemic Shock

Answer 17

Content failure; low volume shock
Hemorrhagic Shock: massive blood loss and internal/external bleeding
Non-Hemorrhagic Shock: vomiting, diarrhea, burns and dehydration
Put patient into shock position

Question 18

Cardiogenic Shock

Answer 18

Pump failure; damage to part of the heart reduces strike volume which reduces cardiac output
Causes AMI (heart attack); heart can’t maintain sufficient output when cardiogenic shock occurs
Put patient in Semi-Fowlers/Fowlers position

Question 19

Obstructive Shock

Answer 19

Physical/mechanical obstruction to blood flow
Causes Pericardial Tamponade, Tension Pneumothorax, and Pulmonary Embolism

Question 20

Pericardial Tamponade

Answer 20

Reduces ventricular filling, causes Beck’s Triad: JVD< muffled heart sounds, and narrowing pulse pressure
Treatment: high flow oxygen and surgery

Question 21

Tension Pneumothorax

Answer 21

Collapses lung and puts pressure on heart and great vessels
S/S: severe dyspnea, JVD, absent lung sounds, tracheal deviation, and narrowing pulse pressure
Treatment: High flow O2, chest compressions, ALS, support breathing, and rapid transport

Question 22

Pulmonary Embolism

Answer 22

Blood clot getting lodged in the lung
S/S: dyspnea, pleuritic chest pain, and pink/frothy sputum
Treatment: High flow O2, support breathing and rapid transport

Question 23

Distributive Shock

Answer 23

Pipe failure and widespread dilation of blood vessels
Includes septic, neurogenic, anaphylactic, and psychogenic shock

Question 24

Septic Shock

Answer 24

Systemic infections, toxins damage vessels, vessels dilate and leak
Treatment: BSI, high flow O2, ventilators support PRN, blankets, hospital management required
Skin Signs: heat, moist, flushed (non-typical)

Question 25

Neurogenic Shock

Answer 25

High spinal injuries, vessels dilate, decreases perfusion
Treatment: BSI, establish/maintain open airway, spinal motion restrictions, assist inadequate breathing, conserve body heat, and transport promptly
Skin Signs: Dry and flushed below injury; warm, dry, and flushed (non-typical)

Question 26

Anaphylactic Shock

Answer 26

Severe allergic reaction, vessels dilate, bronchioles constrict, sever dyspnea, wheezing, flushed skin, and hives/urticaria
Treatment: run primary, high flow O2, ventilators assistance PRN, epinephrine in secondary, and rapid transport ALS

Question 27

Psychogenic Shock

Answer 27

Sudden blood vessel dilation, reduces blood flow to the brain, causes arrhythmias and brain aneurysm
Treatment: Run assessment, O2 if SpO2, assess for injuries, suspect head injury if neurological deficits remain after return on consciousness, and transport even if patient appears normal