Shock (1*) Flashcards
What is it?
What is it defined as?
What’s the first sign seen?
What are its complications?
➊ Inadequate organ perfusion
➋ Haemodynamic instability + evidence of tissue hypoperfusion e.g. cold peripheries, mottled skin, oliguria, raised lactate
➌ Tachycardia
➍ • Cardiovascular collapse
• Acute renal failure
• DIC
• Death
COLD SHOCK:
What causes Hypovolemic shock?
→ What are other less common causes of it?
→ How does it present?
→ How’s it managed?
What is Cardiogenic?
→ What are its causes?
→ How does it present?
→ How’s it managed?
➊ Blood loss
→ D+V (esp. in children), Burns, Polyuria in DKA/DI
→ Cold peripheries, Prolonged CRT, Mottled skin, Rapid/weak/thready pulse
→ Fluid resuscitation and Raise legs
➋ Failure of heart to pump effectively (poor CO)
→ MI, Tension PTX, Cardiac tamponade, Arrhythmia, HF, PE
→ Cold peripheries, Prolonged CRT, Raised JVP, Weak/absent pulse, Arrhythmia, Increased WOB
→ Investigate and treat underlying cause
WARM SHOCK:
What occurs in Septic shock?
→ What’s a key blood test finding here?
→ How does it present?
→ How is it managed?
What occurs in Anaphylactic shock?
→ How does it present?
→ How is it managed?
What are the other causes of this type of shock?
➊ Systemic vasodilation, which causes a drop in BP and organ hypoperfusion. This leads to tissues carrying out anaerobic respiration and releasing lactate as a result.
→ Lactate > 4mmol/L
→ Warm peripheries, Quick CRT, Signs of localised infection
→ Fluid resuscitation, and Abx for primary infection
➋ Severe anaphylactic reaction causing the release of histamine, which causes systemic vasodilation, leading to a drop in BP and organ hypoperfusion
→ Warm peripheries, Quick CRT, Signs of allergy (urticarial rash, angioedema, wheeze, SOB, abdo pain)
→ IM Adrenaline (1:1000), Remove source
➌ • Neurogenic - Severe traumatic brain or spinal cord injury
• Endocrine/Metabolic - Addisonian crisis, Myxedema crisis, Beriberi (Thiamine/B1 deficiency)
