Shock Flashcards
What is a Shock
An acute failure of the circulatory system
results in cellular hypoxia
It is a life-threatening condition
Leads to circulatory failure
What is Normal cellular metabolism?
ATP is the main energy of the cell which is created by aerobic respiration or anaerobic respiration
What condition you require lactate?
Sepsis , we measure the lactic acid build up the higher the lactate -anaerobic respiration
Does shock cause a shift?
Yes, anaerobic respiration
What is cellular injury lead to
It lead to the release of inflammatory mediators and that leads to structural and functional damage to microvasculature
this can lead to mal distribution of blood flow
Hypothermia
Cold
What are the two compensatory mechanisms?
Sympathetic nervous
will increase the HR
and renin-angiotensin mechanism helps to regulate the blood pressure.
Both of these work together to workout cardiac output
Sympathetic nervous system
CO =SV x HR
BP= CO x Systemic Vascular resistance
The sympathetic system causes vasoconstriction which can increase capillary refill times, the skin can go pale
Renin angiotensin mechanisms
it is going to have a direct effect on the kidney
clinical sign - decreased urine output (oliguria)
When compensation fails?
investigate - metabolic acidosis - refer to the lecture slide
4 types of shock
hypovolemic shock (common one)
cardiogenic shock
distributive shock
obstructive shock
Hypovolemic shock
problem in the volume of fluid in the body
it could be blood, plasma, or extracellular fluid
HS leads to
decrease in a lot of things
Bleed? yes, external or internal?
Femoral/pelvis fractures, ecoptic pregnancy, ruptured organ eg spleen/liver
Burns - leaky capillaries and evaporation from burn surface
severe loss of sodium and water - diarrhea and vomiting, dehydration
Cardiogenic shock
Heart problem
bump is failing!
Poor co2, poor organ perfusion and hypoxia
what does cardiogenic shock cause?
Myocardial damage from infarction
Myocarditis
Cardiomyopathy
Sustained arrhythmias
valvular damage
eg endocarditis
compensation of cardiogenic shock
vasoconstriction to
cardiogenic end up
Heart Failure
Obstructive Shock
mechanical obstruction in the flow of blood into / out of the heart
it may be obstruction to cardiac filing or obstruction to cardiac outflow
what causes obstructive shock?
Pulmonary embolism
Tension pneumothorax
Cardiac tamponade
Compensation of obstructive
Cardiac output is reduced
Distributive Shock
Normal blood volume - just not in the right place
characterised by loss of blood vessel tone
Peripheral vascular components increased
Distributive types and causes
What is anaphylatic shock
severe systemic allergic reaction
leads to release of histamine
What can anaphylatic shock lead to?
Death in few minutes if not treated
Clinical features of anaphylatic shock?
Stridor
Cough
wheeze
chest tightness
SOB
abdo pain
skin burning/itching
common causes of anaphylactic shock
penicilin
How do you treat shock?
Airway
Breathing
Circulation
Disability
Exposure
Glasgow coma scale
Best score 15
Lowest 3
VO5
How do you calculate Glasgow coma scale?
Assess patient eye-opening
Verbal response
motor response
