Shock Flashcards

1
Q

Define shock

A

A life-threatening, generalised form of acute circulatory failure with inadequate O2 delivery to, and consequently O2 utilisation by, the cells.

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2
Q

What are the 4 types of shock?

A

1) Hypovolaemic

2) Distributive

3) Obstructive

4) Cardiogenic

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3
Q

Underlying mechanism in hypovolaemic shock?

A

Inadequate circulating volume 2ary to fluid loss

  • haemorrhage e.g. trauma, AAA, obstetric haemorrhage
  • D&V
  • DKA
  • burns
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4
Q

Underlying mechanism in distributive shock?

A

Inadequate perfusion 2ary to maldistribution:

  • sepsis
  • neurogenic shock
  • anaphylactic
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5
Q

Underlying mechanism in obstructive shock?

A

Inadequate cardiac output as a result of mechanical obstruction:

  • PE
  • tension pnuemothorax
  • cardiac tamponade
  • acute IVC or SVC obstruction
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6
Q

Underlying mechanism in cardiogenic shock?

A

Inadequate cardiac output as a result of cardiac failure:

  • myocardial infarction
  • myocardial contusion
  • myocarditis
  • late sepsis
  • overdose (e.g. beta blockers)
  • complete heart block
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7
Q

General presentation of shock?

A

Very unwell:

  • hypotension
  • tachycardia
  • tachypnoea
  • reduced GCS
  • possible cardiac arrest
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8
Q

Presentation of patients in hypovolaemic shock?

A

‘Cold’ shock

  • Cold peripheries due to vasoconstriction
  • Increased CRT
  • May have dry mucous membranes (e.g. if due to dehydration)
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9
Q

Presentation of patients in distributive shock?

A

‘Warm’ shock

  • These patients vasodilate as oppose to vasoconstrict, and are hence often warm with normal CRT
  • If infection (sepsis): underlying signs of infection, rigors, high temp, muscle aches, lethargy, drowsiness, reduced GCS
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10
Q

2 key causes of distributive shock?

A

1) Anaphylaxis

2) Sepsis

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11
Q
A
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