Shock Flashcards
What is shock at its core?
Inadequate perfusion of oxygen to body tissue beginning at cellular level. (result in death of cell up to organism)
T/F Shock is just low blood pressure.
F
DKA can cause shock by:
resultant osmotic diuresis
What is Cushing’s Triad?
1) Bradycardia, 2) HTN w/ widening of pulse pressures, 3) Irregular respirations
What does Cushing’s Triad indicate?
Increased intracranial pressure (cerebral herniation)
Capillaries are made of only tunica __?
Intima
Veins or arteries - which has more tunica media?
veins
Veins or arteries - which has more tunica adventitia?
arteries
What is tunica intima?
smooth muscle
What is tunica adventitia?
fibrous outer layer
What is tunica intima?
Semi-permiable endothelial cells.
Average person’s blood volume:
6 liters
Amount blood can lose w/o noticing
15% (~1 liter)
Amount lost for compensated shock
15%-30% (~1-2 liters)
Amount lost for decompensated shock
35%-45% (~2-3 liters)
Amount lost for irreversible shock
45%+ (roughly half total vol)
Compensated shock response hormone:
epinephrine (catecholamine release - adrenergic response; epi dump)
Compensated shock s/s
inc HR; inc RR; BP normal or mildly elevated; cool, pale, diaphoretic; thirsty/dry mouth; N/V; decreased GI/GU; arteriolar constriction; inc cardiac contractility strength
Decompensated shock s/s
dec BP (LATE sign!); dec HR
Cardiogenic shock means problem with:
pump
Hypovolemic shock means problem with:
fluid
Low resistance shock means problem with
container
Types of low resistant shock (4)
neurogenic, psychogenic, anaphylactic, septic
Neurogenic shock is:
spinal shock; disrupts nerve signals for sympathetic response t/f vasodialation
High cervical injuries in neurogenic shock
Interrupts nerve impules to peripheral nervous sys
Neurogenic shock s/s of skin
warm, dry, and red below the injury; cool, pale, diaphoretic above
Neurogenic shock s/s of vitals
dec HR; dec BP
Neurogenic shock trtmt
Maintain body temperature; IV fluid up to 2 liters (vasopressors not rec for some)
Psychogenic shock example
got scared and fainted
Hypovolemic shock s/s
AMS; cool/pale/diaphoretic; normal BP then drop; normal HR then slow; dec urination; cardiac dysrhythmias; thirsty; dilated pupils
Most forgotten intervention for hypovolemic shock:
Blanket!
What type of fluid for hypovolemic shock?
Crystalloid solution
Old school treatment for shock:
Trendelenberg / raise LE
New treatment for hypovolemic shock
Permissive hypotension (80-90 for PHTLS; 90-100 for ITLS)
Helmets / shoulder pads left in place unless:
Interferes w/ CPR or intubation
If remove one (shoulder pad or helmet), then
The other MUST come off!
Treatment for most sports injuries:
RICE
Check for what before and after splinting?
DNVS
