Shock

Question 1

In a trauma patient, what do we use for fluid resus?

Answer 1

Blood

Question 2

What is the aim of fluid resus in a septic patient?

Answer 2

Help to maintain volume in intravascular space
Flush out toxins

Question 3

Do you do fluid resus in a cardiac arrest?

Answer 3

Depends on the cause e.g hypovalaemia

Question 4

What is meant by a non responder patient in relation to trauma shock?

Answer 4

Patients who have persistent state of shock despite resuscitative efforts. These are the sickest patients

Question 5

What is meant by a transient responder patient in relation to trauma shock?

Answer 5

Patients who initially improve following resuscitative efforts but then subsequently deteriorate. They often have intracavity blood that will require operative management.

Question 6

What is meant by a
responder patient in relation to trauma shock?

Answer 6

A patient who rapidly correct their shocked state with minimal intravascular replacement. These patients do not have ongoing bleeding, or bleeding that has been tamponaded.

Question 7

What are the 3 distinct groups that trauma shock patients are categorised by dependent on their response to resuscitative manoeuvres?

Answer 7

Responders, transient responders and non responders

Question 8

How might a patient with advance stages of shock present?

Answer 8

Unconscious and lack the ability to protect their airway
High RR as the respiratory system attempts to correct the metabolic acidosis associated with tissue hypoperfusion
Cool clammy skin
Altered sensorium
Tachycardia
Hypotension

Question 9

What are the initial events that lead to shock?

Answer 9

Loss of circulating blood volume
Tissue trauma
Pain
Hypoxemia
Hypercarbia
Hypoglycaemia

Question 10

What is traumatic shock?

Answer 10

Body’s response to trauma, think hateful 8

Question 11

What is obstructive shock?

Answer 11

A physical obstruction reducing blood flow, causing a reduced cardiac output e.g PE, tamponade

Question 12

What is inflammatory (septic)
shock?

Answer 12

Infection causing problems in how cells work leading to a drop in BP

Question 13

What is neurogenic shock?

Answer 13

Damage to the nervous system after spinal cord injury that causes the nervous system to have trouble keeping HR, BP and temp stable
Doesn’t occur in injuries below T6

Question 14

What is cardiogenic shock?

Answer 14

The heart suddenly can’t pump enough blood to meet the body’s needs

Question 15

What is hypovolaemic shock?

Answer 15

Sever blood or fluid loos that causes the heart to be unable to pump enough volume around the body

Question 16

What is spinal shock?

Answer 16

Complete loss of all neurological function including reflexes and rectal tone so the level of injury
Normally is transient condition caused by swelling of the cord following injury
Only after the swelling around the cord have subsided can the injury be assessed if temporarily Peary or permanent