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Emergency Medical Technology > Shock > Flashcards

Shock Flashcards

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Royal College: Emergency Medicine flashcards USMLE® Step 1 flashcards
1
Q

What is shock? What is the cause?

A
  1. Shock: widespread inadequate tissue perfusion
  2. Caused: by state of collapse and failure **of the cardiovascular system.
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2
Q

What mechanisms does the body undergo to compensate during shock?

A
  • Tachycardia
  • Vasoconstriction
  • Increased respiratory rate and depth
  • Decreased urine production
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3
Q

What are the four major categories of shock?

A
  1. Hypovolemic
  2. Cardiogenic
  3. Obstructive
  4. Distributive
    5.
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4
Q

What is hypovolemic shock? What can cause hypovolemic shock?

A
  1. Inadequate blood or fluid volume
  2. a. trauma
    b. hemorrhage
    c. burns
    d. dehydration
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5
Q

What is cardiogenic shock? What may onset it? What is another cause?

A
  1. Cardiogenic shock: **heart lacks power to force through circulatory system. **
    - Congestive heart failure (CHF) is out of control
    - inadequat function of the heart or pump failure
    - leads to pulmonary edema
  2. Onset: may be immediate or not apparent hours after Acute myiocardial infarction (AMI)
  3. Dysrhythmias: can also cause cardiogenic shock
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6
Q

What is an obstructive shock? What are some causes?

A
  1. Physical obstruction of blood
    flow
  2. a. tension pneumothorax
    b. cardia tamponade
    c. pulmonary embolus
    d. dissecting aortic aneurysm
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7
Q

What is distributive shock? What are some causes?

A
  1. Widespread reduction of blood vessel tone (vasodilation)
  2. a. neurogenic (spinal chord trauma)
    b. sepsis (dehydration)
    c. anaphylaxis
    d. drugs/overdose
    e. psychogenic
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8
Q

What are the early signs of shock?

A

*At this point the body begins to compensate*

  1. Pale, cool, moist skin
  2. Tachycardia
  3. Delayed capillary refill
  4. Tachypnea
  5. Agitaation/anxiety/restlessness
  6. Altered level of consciousness (ALOC)
  7. Nausea/vomiting
  8. Marked thirst
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9
Q

What are the late signs of shock?

A

*Decompensation has occured*

  1. Includes early signs
  2. Hypotension
  3. Labored irregular breathing
  4. Ashen, mottled, cyanotic skin
  5. Thready or absent peripheral pulses
  6. Dilated pupils
  7. Poor urinary output
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10
Q

When would you expect shock?

A
  1. Multiple severe fractures
  2. Abdominal or chest injuries
  3. Spinal injuries
  4. Severe infection
  5. Major heart attack
  6. Anaphylaxis
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11
Q

What is the treatment for shock?

A

Treatment does not vary with types of shock

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12
Q

What are the actual_ _treatments for shock?

A
  1. Maintaining airway
  2. Control external bleeding
  3. Shock position
  4. High flow oxygen
  5. Rapid transport
  6. Keep warm
    _*Do not give the patient anything by mouth*_
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13
Q

What are the ALS considerations?

A
  • IV fluid“challenges” (hypovolemic)
  • Medications (cardiogenic/distributive)
  • MAST or medical anti shock trousers
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14
Q

What may indicate dehydration?

A

History of:

  • Nausea
  • Vomiting
  • Exertion
  • Diarrhea
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15
Q

What are some signs of Dehydration?

A
  • Dry mucus membranes
  • Sunken eyes
  • Decreased urination
  • Poor skin turgor
  • The degree of elasticity of skin
  • look at fontenelles for pediatrics
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16
Q

What is eqaution for blood pressure?

A

BP = CO x PVR

17
Q

What is cardiac output? How do you calculate it?

A
  1. Cardica output: the amount of blood pumped by the left ventricle over 1 minute
  2. CO = stroke volume x BPM(beats per minute)
18
Q

What is stroke volume?

A

The amount of blood pumped by the left ventricle in one contraction

19
Q

What is peripheral vascular resistance? What is it determined by?

A
  1. The force against which the heart has to beat
  2. Partially determined by the size of the blood vessels
20
Q

WHat are the causes of shock?

A
  1. Pump Failure:
    - cardiogenic
    - obstructive
  2. Poor vessel function; Obstructive shock:
    - septic shock
    - neurogenic shock
    - anaphylactic
    - psychogenic
  3. **Low fluid volume; Hypovolemic: **
    - hemorrhagic
    - nonhemorrhagic
21
Q

What is Cardiac tamponade?

A
  • A collection of fluid between the pericardial sac and myocardium
  • Casued by blunt or penetrating trauma

Emergency Medical Technology (22 decks)

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