Shock Flashcards
What is the top priority of the circulatory system?
Maintain perfusion (blood pressure/flow) to vital organs
Perfusion is essentially equivalent to?
Blood pressure (BP)
What are the determinants of Perfusion (BP)?
Cardiac output (CO) = HR X SV Systemic Vascular Resistance (SVR) -- BP = CO X SVR
What determines the stroke volume?
Preload
Afterload
Contractility
What is Shock?
Inadequate tissue perfusion (BP) to meet metabolic and oxygenation demands
What is Shock?
Inadequate tissue perfusion (BP) to meet metabolic/oxygenation demands
If Shock is categorized by stage, what are the stages?
- Compensated
- Decompensated
- Irreversible
Compensated Shock
Compensatory mechanisms (+) and perfusion is maintained = HR elevated and peripheral vessels constrict to shunt blood centrally
Decompensated Shock
Hypotension and Lactic Acidosis
Irreversible Shock
Organ and tissue injury are too severe for survival
If Shock is categorized by physiology, what are the options?
- Cardiogenic
- Hypovolemic
- Distributive
- Obstructive
If Shock is categorized by physiology, what are the options?
- Cardiogenic
- Hypovolemic
- Distributive
- Obstructive
Cardiogenic Shock
- Due to a bad pump
CO = decreased
SVR and CVP = increased
What usually causes Cardiogenic shock?
Heart muscle problems (cardiomyopathies),
rhythm problems, valvular/congenital issues
Hypovolemic Shock
- Due to decreased intravascular volume
CO = decreased
SVR = Increased
CVP = decreased
What usually causes Hypovolemic Shock?
Blood loss
Non-hemorrhagic = dehydration, cirrhosis, burns
Distributive Shock
Dilated peripheral vasculature
CO = increased
SVR and CVP = decreased
What are some causes of Distributive Shock?
Neurogenic (brain/spinal cord injury)
Septic
Anaphylactic
Toxins
What are some causes of Distributive Shock?
Neurogenic (brain/spinal cord injury)
Septic
Anaphylactic
Toxins
CO, SVR and CVP levels for Distributive Shock besides Neurogenic
CO = increased
SVR and CVP = decreased
– Neurogenic = ALL DECREASED
Obstructive Shock
- Due to mechanical obstruction of blood flow
CO = decreased
SVR = increased
CVP = variable
CVP
Central venous pressure
What are the physical signs of Shock?
Hypotension, Tachycardia, Tachypnea
Cyanotic, oliguria and altered mental status
What are the physical signs of Shock?
Hypotension, Tachycardia, Tachypnea
Cyanotic, oliguria and altered mental status
What are the metabolic signs of Shock?
Elevated serum lactate
Metabolic acidosis
What is the treatment of Shock?
ABC - Airway, Breathing, CIRCULATION
= Restore tissue perfusion and treat underlying cause
ex. IVF, vasopressors
What are the special populations that may present differently with Shock?
Kids
Elderly
