Shock

Question 1

Perfusion

Answer 1

• the constant supply of oxygen and nutrients (glucose) to the body tissues as a result of constant passage of blood through the capillaries

Question 2

Fick Principle

Answer 2

• defines what is necessary to achieve end tissue perfusion
– On loading of O2 to RBC
– Delivery of RBC to the tissue
– Off loading of O2 to the tissue

Question 3

Shock

Answer 3

• “Inadequate perfusion of the body tissues, resulting in an inadequate supply of oxygen and nutrients to the body tissues”

• Shock is “Staged Death”
– Shock occurs first at the cellular level and progresses to the tissues, organs, organ systems, and ultimately the entire organism.
– It is the body’s transition between normal function and death

Question 4

San Diego County Protocol: “Shock” is defined by the following criteria: (S-101)

Answer 4

1. ≥ 15 years:
• Systolic BP 180bpm; >5yrs >160bpm)
– pallor, mottling or cyanosis
– diaphoresis
– comparison (difference) of peripheral vs. central pulses
– delayed capillary refill
– systolic B/P < [70+(2 X age)]  

2. 180bpm; >5yrs >160bpm)
– pallor, mottling or cyanosis
– diaphoresis
– comparison (difference) of peripheral vs. central pulses
– delayed capillary refill
– systolic B/P < [70+(2 X age)]

Question 5

Types of Shock

Answer 5

• Cardiogenic – Pump: Heart
• Distributive – Pipe: Vessel, Anaphylaxis, Septic, Psychogenic
• Obstructive – Something that disrupts/blocks blood flow
• Hypovolemic – Volume depletion: Blood or other body fluids

Question 6

Hypovolemic Shock

Answer 6

• Hemorrhagic or Metabolic
• Loss of intravascular fluids
• Trauma
• Long bone fracture
• Dehydration – Metabolic
• Burns with plasma loss
• Excessive diaphoresis
• DKA with osmotic diuresis

Question 7

Cardiogenic Shock

Answer 7

• Inability of heart to meet demands of body
• Causes:
– CHF/MI
– Tachycardia
– Bradycardia
– Significant S/S
– Fluid in lungs
– Early cyanosis

Question 8

Obstructive Shock

Answer 8

• Fluids in body but not able to move
– Dissecting aortic aneurysm
– Cardiac tamponade
– Tension pneumothorax

Question 9

Distributive Shock

Answer 9

• Fluids in body bot not in vasculature
– Neurogenic
– Septic
– Anaphylactic