Shock Flashcards
Definiton
Circulatory failure resulting in inadequate tissue perfusion
Cause
Inadequate CO/ hypovolaemic
- bleeding or fluid loss (vomiting, burns)
Loss of systemic vascular resistence -SVR (peripheral circulatory failure) pumping fine but not going to the right places.
- Septic shock, anaphylaxis and neurogenic are all types of distributive shock
Sepsis
systemic inflammatory response syndrome (SIRS) in the presence of infection
Infection causes acute vasodilation from inflammatory cytokines
Severe sepsis
sepsis with organ hypoperfusion
septic shock
severe sepsis with hypotension
Anaphylaxis
type 1 IgE mediated hypersensitivity reaction
Release of histamine and other agents causes hemodynamic collapse + symptoms
Precipitants for anaphylactoid reaction
(results from direct release of mediators/cytokines form inflammatory cells)
drugs, latex, stings, eggs fish etc
Example of neurogenic shock
spinal cord injury, epidural or spinal anaesthesia
Signs of shock
tachycardia tachypnoea pallor oliguria slow capillary refill time decreased GCS
what does cold + clammy suggest?
cariogenic shock or fluid loss
what does warm + well perfused suggest?
septic shock
Mx hypvolameic shock
fluids/blood transfusion, FFP (fresh frozen plasma)/platelets
Causes of cariogenic shock
Basically HF- MI, arrhythmia, myocarditis, valvular problems
secondary- PE, tension pneumothorax, cardiac tamponade
Mx cariogenic shock
O2 and treat underlying cause
Tx for anaphylactic shock
secure airway
adrenaline
chlorphenamine + hydrocortisone IV
