Shock

Question 1

Definition of shock

Answer 1

Inadequate tissue perfusion and oxygenation.

Question 2

Broad classification of shock

Answer 2

1. Haermohagic
2. Non hemorrhagic

Question 3

Non hemorrhagic shock

Answer 3

1. Cardiogenic shock
2. Neurogenic shock
3. Septic shock
4. Obstructive shock( Tension Pneumothorax)

Question 4

Hemorrhagic shock

Answer 4

1. Hypovolemic shock

Stages of shock
1. Initial : Cardiac output is decreased and tissue perfusion is threatened but patient is still hemodynamically stable.

2. Compensatory : Almost immediately ,the compensatory stage begins as the body s homeostatic mechanisms attempt to maintain cardiac output, blood pressure and tissue perfusion
3. Progressive : The compensatory mechanisms begin failing to meet tissue metabolic needs, and the shock cycle is perpetuated
4. Refractory/ Irreversible : Non responsive to therapy

Question 5

ATLS stages of shock

Answer 5

1. Class I Shock: Blood loss up to 750 mL (15% of blood volume). Symptoms may include slight tachycardia, slight hypotension, and a normal blood pressure. The patient may be mildly anxious but generally maintains normal mental status and urine output.
2. Class II Shock: Blood loss of 750-1500 mL (15-30% of blood volume). Symptoms include moderate tachycardia, slightly low blood pressure, and a slight decrease in urine output. The patient may experience mild to moderate anxiety and a slight increase in respiratory rate.
3. Class III Shock: Blood loss of 1500-2000 mL (30-40% of blood volume). Symptoms include marked tachycardia, hypotension, confusion, and a significant drop in urine output. The patient may show signs of confusion or lethargy and has an increased respiratory rate.
4. Class IV Shock: Blood loss greater than 2000 mL (over 40% of blood volume). Symptoms include very high tachycardia, severe hypotension, altered mental status (such as lethargy or confusion), and very low urine output. The respiratory rate is often very high, and the patient is at high risk for organ failure.

Question 6

Distributive Shock

Answer 6

Caused by widespread vasodilation and a decrease in systemic vascular resistance, leading to inadequate blood flow to tissues.

Subtypes include:

1. Septic Shock: Due to severe infections causing systemic inflammatory response.
2. Anaphylactic Shock: Caused by a severe allergic reaction leading to widespread vasodilation.
3. Neurogenic Shock: Results from spinal cord injury or other conditions causing loss of sympathetic tone and vasodilation.

Question 7

Obstructive Shock

Answer 7

Occurs when there is a physical obstruction in the circulatory system preventing proper blood flow. Examples include pulmonary embolism, tension pneumothorax, and cardiac tamponade.

Question 8

Cardiogenic Shock

Answer 8

Results from the heart’s inability to pump blood effectively, usually due to conditions like myocardial infarction (heart attack), severe heart failure, or arrhythmias.