OnlineMedEd: Intern Content - "Shock I" Flashcards
Review the equation for MAP.
MAP = CO x SVR
or
MAP = HR x SV x SVR
or
MAP = HR x preload x contractility x SVR
Disorders that lead to _____________ are called warm shock. Examples include neurogenic shock, anaphylaxis, and sepsis.
decreased SVR
With decreased SVR, the extremities get extra blood and remain warm.
Disorders that lead to _____________ are called cold shock. Examples include cardiogenic, obstructive, and hypovolemic.
increased SVR
With increased SVR, the extremities get less blood and get cold.
What vital sign is indicative of shock from decreased CO?
Narrowed pulse pressure
This indicates increased SVR, which could result from cardiogenic, hypovolemic, or obstructive shock.
What vital sign is suggestive of distributive shock?
Widened pulse pressure (particularly due to loss of diastolic pressure)
This indicates decreased SVR (anaphylaxis, neurogenic shock, anesthesia, sepsis, Addison’s)
Where, specifically, should you feel for warm vs. cold shock?
The extremity proximal to the end (like the shin or the wrist –not the toes or fingers)
What is the treatment for SVT refractory to vasovagal maneuvers?
Cardioversion
What is the treatment for bradycardia-induced shock?
Pace
List the two kinds of obstructive shock that affect the right heart and the two kinds of obstructive shock that affect the left heart.
Right:
- Tension pneumothorax
- Tamponade
Left:
- Pulmonary HTN
- PE
What are the two most common causes of shock from contractility?
MI and CHF
The shock index is given by what values?
HR > SBP
Describe occult shock.
Occult shock is when a person who is normally hypertensive presents in shock with normal BP.
Example: guy has 180/100 pressures normally in clinic and then shows up in the ED in shock with a BP of 120/80.
