shock Flashcards
shock?
tissue hupoperfusion due to circulatory failure
if mean arterial pressure is below?, there is slow flow to organs , leading to thrombus formation and inadequate perfusion for cellular metabolic requirements
50 - 60mmhg
inadequate perfusion leads to ?
acidosis and lactate formation
inadequate perfusion causes?
systemic acidosis
systemic acidosis ph?
less than 7.35
micro capillary thrombus with patchy tissue injury also
eventual cellular necrosis results in mortality
in survivors, a degree of tissue injury may be irreversible, contributing to chronic morbidity
y
recognition of shock?
mottling
glasgow coma scale of less than 15 (confusion and agitation)
urine output
confirmation?
lactate levels
even 0.75mmol/L higher than normal carries a worse prognosis
>2mmol/L arguably diagnostic
>4mmol/L significant mortality
remember you can be shocked without being hypotensive
and hypotensive patients don’t necessarily have shock
what is cariogenic shock>
reduced force of contraction and stroke volume therefore - reduced cardiac output and reduced mean arterial pressure
why do you get cool clammy peripheries?
compensatory increase in SVR
Obstructive shock?
evidence of raised jugular venous pressure and distended neck veins may be prominent
distended neck veins?
obstructive shock
obstructive shock causes?
TP, PE, CT
hypovolaemic shock?
reduced blood volume
lower venous return to the heart
reduced force of cardiac contraction
which curve shows voume and stroke volume?
frank starling curve (there is a peak contraction
hypovolaemic shock - peripheries?
cold, clammy
treatment?
find and stop bleeding
reduced systemic vascular resistance, due to vasodilation, with warm, red peripheries
distributive shock
why do you get a reduced mean arterial pressure?
SVR decreased. CO x SVR = MAP
cause of distributive shock?
sepsis, anaphylactic shock or spinal cord damage
