Shock

Question 1

Hypovolaemic Shock - causes

Answer 1

Haemorrhage (internal/eternal bleeding)
Salt + water loss (vomiting, diarrhoea, burns, polyuria)
3rd space loss (ascites, acute pancreatitis)

Question 2

Cardiogenic Shock - causes

Answer 2

Pump failure (LV dysfunction, aortic dissection, dysrhythmia) 
Inadequate filling (PE, pneumothorax, cardiac tamponade)

Question 3

Septic Shock - common sources of infection

Answer 3

Chest - pneumonia
Skin/soft tissue - cellulitis, gangrene
Heart - endocarditis
Abdo - perforation, biliary tract
Urinary tract - UTI, pyelonephritis
Post-op - wound infection, bowel leak

Question 4

Spinal (neurogenic) Shock - causes

Answer 4

Trauma of spinal cord at any level

Spinal anaesthesia

Question 5

Investigations

Answer 5

HR
BP
RR
FBC, U+E, LFT, amylase, clotting, osmolality, cross-match, CRP/ESR, glucose
ECG (if cardiogenic)
ABG
Blood/skin/urine cultures (sepsis)
Imaging for internal bleeding (haemorrhagic)

Question 6

Basic treatment

Answer 6

Oxygen
Elevate legs if appropriate
IV access (2x large bore cannulae) 
1L 0.9% saline STAT, repeat if no change in HR/BP
IV antibiotics (sepsis)

Question 7

Sepsis Six

Answer 7

Oxygen
IV fluids (1L 0.9% saline STAT)
IV antibiotics (see local guidelines)
Lactate
Urine output
Blood cultures (before abx)