Shock Flashcards
Initial stage of shock
May not be apparent
Body begins to respond to oxygen supply and demand imbalance
Shock definition
State in which blood flow become inadequate or cells become unable to remove toxins or use oxygen.
Compensatory phase
Lactic acid builds up
Decrease in tissue perfusion
Tachycardia tachypnea
Progressive stage
Unable to compensate for decreased CO
Failure to maintain BP
Results in multi system organ failure if not corrected
Refractory stage
Resistant to therapy
Irreversible tissue ischemia and damage
Cell damage leading to death
Cardiogenic shock
Compromised cardiac output
Not a fluid balance problem
Echo to check ejection fraction, normal is 70-100
Causes of cardiogenic shock
Acute MI Cardiomyopathy Pulmonary hypertension Blunt cardiac injury Sepsis
Treatment of cardiogenic shock
Increase cardiac contractility
Reduce cardiac workload
Decrease water and sodium retention
Diuretics
Lasix. Decrease fluids do heart doesn’t work as hard.
IABP
Intra-aortic balloon pump facilitates emptying of left ventricle
Hypovolemic shock
Fluid problem. Too little.
Causes of hypovolemic shock
Blood loss Plasma loss (burns) Vomiting Diarrhea Diabetes
Treatment of hypovolemic shock
Find and restore fluid imbalance and restore tissue perfusion
Universal donor (blood)
Type O negative
Septic shock
Infection in the blood leading to altered tissue perfusion.
Risks for sepsis
Recent trauma Surgery Invasive procedures Malnourished Immunosuppressed
Septic shock causes
Gram negative bacteria UTIs Parasites Fungus Virus
Third spacing
Fluid going into interstitial spaces
Sepsis treatment
Reverse vasodilation
Remove cause
Maintain tissue perfusion
Fluid resuscitation
Crystalloid fluids: NS and LR
Levophed
Norepinephrine vassoconstrictor
Lactate levels
Normal is 0.5-2.4
Neurogenic shock
Loss of sympathetic tone resulting in dilation.
Temporary associated with spinal cord injury
Treatment of neurogenic shock
Drugs to improve vasomotor tone
Reverse vasodilation
Maintain tissue perfusion
Fluids with neurogenic shock
Be cautious with fluid use. Opt to use vasoconstrictors instead.
Dopamine
Vasoconstrictor treats bradycardia
Anaphylactic shock
Result of allergic reaction. Causes respiratory distress. Can be life threatening.
Treatment of anaphylactic shock
MAINTAIN AIRWAY BY WHATEVER MEANS NECESSARY
Epinephrine
Drug of choice of anaphylaxis. Bronchodilator counteracts histamine response
Corticosteroids
Use in anaphylaxis to decrease inflammation
