Module 9: Shock Flashcards
What is perfusion?
adequate delivery of blood to all tissues of the body as well as the removal of waste
What makes good perfusion?
Healthy heart (pump), flood (fluid), and vessels (pipe)
What is shunting?
The blood vessels redirecting blood from less essential areas of the body to more essential
Describe the first sign of hypoperfusion
AMS such as confusion and restlessness
What are the four categories of shock?
hypovolemic, distributive, cardiogenic, obstructive
What is hypovolemic shock?
Loss of fluid like blood, plasma, and water
If the body has lost fluid, how would the body initially compensate for the loss?
vasoconstriction and pulse increase
skin becomes pale and moist
What are the universal treatments for shock?
maintaining body temp, position of comfort, and oxygen
What are the characteristics of distributive shock?
vessels start to dilate, and capillaries begin to leak, causing blood to occupy space between capillary and the cell
neurogenic, psychogenic, anaphylaxis, septic
What are characteristics of neurogenic shock?
It is a type of distributive shock, which is characterized by fluid loss
-dilated vessels in spinal cord
-absence of sweating
-loss of body temp control
-low BP
-body is unable to shunt blood
-ventilation may become a problem (think about how brain stem controls ventilation)
-erection may form in XY pts
What are the characteristics of psychogenic shock?
sudden dilation of blood vessels
dip in BP
relatively quick recovery
What are the characteristics of anaphylactic shock?
autoimmune condition in which body’s senses a threat from an outside source, so it releases chemical mediators. Type of distributive shock.
-the release causes: vasodilation, capillary leaking, bronchioles constriction
What types of shock induce brochiole constriction?
anaphylactic shock, induces wheezing
Describe dose for epi in anaphylactic shock in children and adults?
adult (>=66 lb): 03mg
children (<66 lb): 0.15mg
What is sepsis?
A body’s overwhelming and life threatening response to infection that may lead to death.
What is CHART? What is CHART for sepsis?
C: Chief complaint
H: History (recent infections)
A: Assessment (Vital signs that pertain to perfusion: BP, MAP, Respiration. Pulse ox, temperature)
R: Red flags
T: Treatment (fluids, 30mL per kg)
What are the two criteria for sepsis?
suspected infection, organ dysfunction
Infection + bad vitals=
Sepsis
Sepsis+ Shock=
Septic shock
What is the most common infection that results in sepsis?
Bacteria
Sepsis causes blood vessels to ___ and capillaries to __
dilate, leak
When should you lay a patient with cardiogenic shock down?
Never
How should an EMT treat a pt with cardiogenic shock?
324 mg aspirin
keep warm
Oxygen
Describe the characteristics of cardiac tamponade
Type of obstructive shock
Usually after chest trauma like gsw or puncture
fluid build up in pericardial sac
What are the signs of symptoms of cardiac tamponade?
Beck’s triad
-muffled heart sounds
-jugular venous distension (JVD)
-systolic and diastolic begin to narrow
Tension pneumothroax characteristics?
Type of obstructive shock
air leaks out of lung into pleural space
shift towards media sternum and pushes onto heart and trachea
is trachea midline? if no possibility of tension pneumothorax
Compare pneumothorax to a tension pneumothorax
pneumothorax does not contain a shift
What is a pulmonary embolism?
type of obstructive shock
clot travels into pulmonary circulation to prevent gas exchange
signs and symptoms: SOB, tachypnea, chest pain, low pulse ox despite oxygen
What are the three stages of shock?
Compensated (SBP above 90)
decompensated (SBP below 90)
Irreversible
Neurogenic and psychogenic ___ while anaphylaxis and septic include
vessel dilation
vessel dilation and leakeage
A 33-year-old woman presents with a generalized rash, facial swelling, and hypotension approximately 10 minutes after being stung by a hornet. Her BP is 70/50 mmHg and her heart rate is 120 beats/min and she is vomiting. In addition to high-flow oxygen, this patient is in MOST immediate need of:
epinephrine, 0.3mg
39-year-old male sustained a large laceration to his leg during an accident with a
chainsaw and is experiencing signs and symptoms of shock. You should first:
1. perform a rapid head-to-toe
2. place pt on oxygen
3. apply direct pressure
4. place a blanket on the pt
- apply direct pressure
Hypovolemic shock occurs when:
1. patient has SBP less then 100 mmHg
2. At least 10% of blood volume i slost
3. Body cannot compensate for rapid blood loss
4. clotting ability is enhance
- Body cannot compensate for rapid blood loss
A patient with neurogenic shock would be LEAST likely to present with:
1. hypotension
2. cool skin
3. tachypnea
4. altered mental status
- cool skin
A 60-year-old woman presents with a BP of 80/60 mm Hg, a pulse rate of 110 beats/min, mottled skin, and a temperature of 103.9°F. She is MOST likely experiencing:
septic shock
Anaphylaxis results in
1. vessel dilation
2. symptomatic hypertension
3. capillary leaking
4. constriction of bronchioles
- vessel dilation
- capillary leaking
- constriction of bronchioles
