Shock Flashcards
What is shock?
Acute circulatory collapse where the circulation is unable to transport
sufficient oxygen to the tissues needs
Tissue Perfusion adequate requirements.
right volume at right pressure
BP is dependant on
1.The cardiac output
2.The systemic vascular resistance
(Size of blood vessels/leakyness)
What happens to cells due to shock
- Inadequate supply of O2
- Inadequate supply of nutrients
- Inadequate removal of metabolic waste -> abnormal cell function
4 types of shock
- Hypovolaemic
- Distributive
-Septic, Toxic, Anaphylactic - Cardiogenic
- Obstructive
Hypovolaemic Shock
Caused by a reduction in the effective circulating intravascular volume
Intravascular fluid losses.
(3)
1.Fluid loss affecting the intravascular space only
* Early haemorrhage
2. Fluid and salt loss
* Vomiting or diarrhoea
3. Third space losses
* Loss of fluid into a body cavity
Signs of Hypovolaemic shock
- Tachycardia
- Prolonged CRT
- Pale MM
- Poor pulse quality
- Low blood pressure
Catecholamines?
Hormones made by your adrenal glands
(adrenaline and noradrenaline)
positive inotropy
strengthen the heart’s contractions, so it can pump more blood with fewer heartbeats.
positive chronotropy
increases heart rate
Distributive Shock
abnormal blood
volume distribution due to a
generalised and excessive
dilatation of the blood vessels
Signs of distributive shock
DARK PINK/
RED MM
SLOW CRT
3 types of distributive shock
- Neurogenic shock
* CNS trauma causing acute vasodilation - Anaphylactic shock
* allergic reaction - Endotoxic shock
* Septic shock
Cardiogenic shock
The heart is unable to pump the blood adequately around the body
Cardiogenic shock causes
- Cardiomyopathy
- Heart valve disease
- Severe arrhythmias
Cardiogenic shock signs
- Heart murmur
- Irregular pulses
- Tachycardia or bradycardia
Obstructive Shock
Obstruction of the blood flow through the heart or back to the heart
What does obstructive shock look like?
- Heart murmur
- Irregular pulses
- Tachycardia or bradycardia
Crystalloids
Electrolyte solutions
-Isotonic, hypertonic and hypotonic
what do Isotonic crystalloids do?
Replacement fluids
* OP and electrolytes similar to
ECF
What do hypertonic crystalloids do
Expands plasma volume by
drawing fluid out the cells into the
extracellular space
Colloids
Contains molecules with a large
molecular weight
* They cannot leave the vascular system
Whole Blood transfusions indications
Haemorrhage
Types of Arresting Haemorrhage methods
External haemorrhage control
Internal haemorrhage control
Internal haemorrhage control methods
Abdominal belly wrap
Abdominal belly wrap must be removed after…how long?
12 hours
External haemorrhage control
Direct digital pressure
Artery forceps
Pressure dressing
Cold compress
Complications of Fluid Therapy
Air embolisms
Cardiac disease
Renal insufficiency
Patients with lung pathology
Increased intracranial pressure
Paediatrics
Hyperperfusion signs
- Tissue oedema
- Chemosis – oedema of conjunctiva
- Oedema of distal limbs and face
- Pulmonary oedema
(Rales, dyspnoea, moist cough,
tachypnoea) - Nasal discharge
- Lethargy
Hypoperfusion signs
No improvement of the symptoms of shock
