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EMERGENCY MEDICINE > SHOCK > Flashcards

SHOCK Flashcards

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Royal College: Emergency Medicine flashcards
1
Q

BASIC CARDIAC PHYSIOLOGY

volume of blood that is pumped by the heart per minute
-> amount of blood being supplied by the heart per minute

A

cardiac output

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2
Q

an abnormality of the circulatory system that results in inadequate organ perfusion and tissue oxygenation

A

SHOCK

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3
Q

BASIC CARDIAC PHYSIOLOGY

determined by preload, myocardial contractility, afterload
-> amount of blood being pumped out per heartbeat

A

stroke volume

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4
Q

BASIC CARDIAC PHYSIOLOGY

initial amount of blood present in the right atrium
volume of venous blood return to the left and right sides of the heart

A

preload

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5
Q

BASIC CARDIAC PHYSIOLOGY

is the pump that drives the system
if there will be an opposing resistance or force hindering the outflow of the blood from the heart

A

afterload

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6
Q

BLOOD LOSS PATHOPHYSIOLOGY

progressive ______ of cutaneous, muscular, and visceral circulation to preserve blood flow to the kidneys, heart, and brain

A

vasoconstriction

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7
Q

BLOOD LOSS PATHOPHYSIOLOGY

___________ is the earliest measurable circulatory sign of shock

A

tachycardia

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8
Q

TYPES OF SHOCK
_________ is the most common cause of shock

A

hemorrhage

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9
Q

TYPES OF SHOCK
HEMORRHAGIC SHOCK: CLASS

exemplified by the condition of an individual who has donated 1 unit of blood

compensatory mechanism will restore blood vol. within 24 hours, usually without the need of blood transfusion

A

Class 1 Hemorrhage
<15%

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10
Q

TYPES OF SHOCK
HEMORRHAGIC SHOCK: CLASS

uncomplicated hemorrhage for which crystalloid fluid resuscitation is required

tachycardia, tachypnea, and decreased pulse pressure

A

Class 2 Hemorrhage
(15-30%)

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11
Q

TYPES OF SHOCK
HEMORRHAGIC SHOCK: CLASS

complicated hemorrhagic state in which at least crystalloid infusion is required and most will need blood products to reverse shock state

A

Class 3 Hemorrhage
(>40%)

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12
Q

NON-HEMORRHAGIC SHOCK

suspect a blunt cardiac injury when the mechanism of injury to the thorax involves rapid deceleration

myocardial dysfunction can be caused by blunt cardiac injury, cardiac tamponade, an air embolus or MI

A

cardiogenic shock

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13
Q

NON-HEMORRHAGIC SHOCK

commonly seen in patients with penetrating thoracic injury

Beck’s triad

A

cardiac tamponade

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14
Q

NON-HEMORRHAGIC SHOCK

can also present similar manifestations of cardiac tamponade - distended neck veins and hypotension

develops when air enters the pleural space but a flap valve mechanism prevents its escape

A

tension pneumothorax

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15
Q

NON-HEMORRHAGIC SHOCK

brainstem injuries

cervical and upper thoracic spinal cord injuries can cause hypotension —> loss of sympathetic tone

A

neurogenic shock

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16
Q

NON-HEMORRHAGIC SHOCK

occur when a patient’s arrival at the ED is delayed for several hours

patients with early septic shock can have a normal circulating volume, modest tachycardia, warm skin, near normal SBP and a wide pulse pressure

A

septic shock

17
Q

BLOOD REPLACEMENT

complete crossmatching process approximately 1 hour

if crossmatched blood is unavailable, type O PRBC are indicated for exsanguinating hemorrhage

A

crossmatched type specific, and type O blood

18
Q

NON-HEMORRHAGIC SHOCK

heat fluid to 39C before infusion

accomplished by storing crystalloids in a warmer or infusing them through intravenous fluid warmers

A

prevent hypothermia

19
Q

NON-HEMORRHAGIC SHOCK

> 10 of PRBC within the 1st 24 hours of admission or more than 4 units in 1 hour

A

Massive transfusion

20
Q

NON-HEMORRHAGIC SHOCK

consider collection of shed blood for AT in patients with massive hemothorax

blood generally has only low levels of coagulation factors so plasma and platelets may still be needed

A

Autotransfusion

21
Q

NON-HEMORRHAGIC SHOCK

severe injury and hemorrhage result in consumption of coagulation factors and early coagulopathy

A

COAGULOPATHY

22
Q

BLOOD PRODUCTS

contains all coagulation factors
lasts up to 1 yr. frozen

A

fresh frozen plasma

23
Q

BLOOD PRODUCTS

refrigerated up to 42 days
usually for HgB less than or equal 7 g/dL

A

Packed RBCs

24
Q

BLOOD PRODUCTS

precipitate of thawed FFP
high factor Factor VIII (antihemophilic factor) and fibrinogen

A

cryroprecipitate

25
Q

BLOOD PRODUCTS

must be agitated to prevent clumps
room temp up to 5 days

A

Platelets

EMERGENCY MEDICINE (12 decks)

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