Shock

Question 1

What is the equation for cardiac output?

Answer 1

heart rate x stroke volume

Stroke volume determined by preload, contractility and afterload

Question 2

What is the shock index?

Answer 2

HR / SBP

Question 3

Is initial tissue hypoxia reversible in early shock?

Answer 3

Yes

Question 4

A 45-year-old male presents to the emergency department with severe chest pain, diaphoresis, and shortness of breath. His blood pressure is 70/40 mm Hg, heart rate 120 bpm, and oxygen saturation is 92%. On examination, the patient appears pale and anxious. Which type of shock is most likely in this patient?

Answer 4

Cardiogenic

Question 5

What systems are involved in anaphylactic shock?

Answer 5

• Respiratory
• Circulatory
• GI

Question 6

What is the drug cocktail for anaphylaxis?

What helps prevent late shock?

Answer 6

• Epi IM
• Steroids
• PPI’s (Famotadine)
• Albuterol

Steroids

Question 7

After anaphylactic shock and administration of epinephrine what is the observation time in the ED?

What should be continued upon disposition to home?

Answer 7

4 Hours

Steroids and antihistamines

Discharge with EpiPen in hand!

Question 8

If you have to administer two epi doses in anaphylactic shock what needs to happen?

Answer 8

Patient gets admitted

Question 9

A 32-year-old female patient is brought to the emergency department following a motor vehicle accident. She has multiple rib fractures and decreased breath sounds on the right side. Her blood pressure is 90/60 mm Hg, heart rate 110 bpm, and respiratory rate 28/min. Which type of shock is most likely in this patient?

Answer 9

Obstructive shock

occurs when there is physical obstruction to blood flow, preventing the heart from filling or ejecting blood effectively. In this case, the patient’s rib fractures have likely led to a pneumothorax or hemothorax, which can physically impede the heart’s ability to pump blood. The decreased breath sounds and hypotension are characteristic of this condition.

Question 10

What is the treatment for cardiogenic shock?

Answer 10

Must maintain the MAP to perfuse brain and heart

Can give a small bolus but must monitor carefully

Question 11

A 60-year-old male patient with a history of chronic obstructive pulmonary disease (COPD) presents to the ED with acute dyspnea and a prolonged history of productive cough. On examination, the patient is found to have decreased breath sounds on one side and hyperresonance on percussion. What type of shock is most likely in this patient?

Answer 11

Obstructive Shock

Question 12

What is combined shock?

Answer 12

Patients often have combination of one type that leads to another