Shock

Question 1

Define shock.

Answer 1

A clinical syndrome where perfusion and therefore oxygenation is too low to sustain normal metabolic function.

Question 2

Define 3 types of shock.

Answer 2

Hypovolaemic - loss of fluid or blood - haemorrhage, burns, dehydration

Cardiogenic - pump failure

Septic - occurs from sepsis after an infection, causing leaking capillaries and vasodilation.

Question 3

What effect does shock have on heart rate and respiratory rate?

Answer 3

They go up!

Question 4

What effect does shock have on blood pressure and organ function (I.e urine output)?

Answer 4

They go down!

Question 5

What volumes of blood loss correspond to different classes of shock?

Answer 5

Up to 750ml - class 1
750-1500ml - class 2
1500ml-2000ml - class 3
>2000ml - class 4

Question 6

What percentage of blood loss correspond to different classes of shock?

Answer 6

Up to 15% - class 1
15-30% - class 2
30-40% - class 3
>40% - class 4

Question 7

What pulse rates correspond to different classes of shock?

Answer 7

<100 - class 1
100-120 - class 2
120-140 - class 3
>140 - class 4

Question 8

What blood pressure statuses correspond to different classes of shock?

Answer 8

Normal - class 1&2
Lowered - class 3&4

Question 9

What respiratory rates correspond to different classes of shock?

Answer 9

14-20 - class 1
20-30 - class 2
30-40 - class 3
>40 - class 4

Question 10

What urine outputs refer to different classes or shock?

Answer 10

>30ml/hr- class 1 
15-30ml/hr- class 2 
5-15ml/hr- class 3
Negligible- class 4

Question 11

What mental statuses refer to different levels of shock?

Answer 11

Normal- class 1
Mild anxiety- class 2 
Anxiety - class 3
Confused- class 4

Question 12

What is an abrasion and how is it treated?

Answer 12

Caused by dragging against an irregular surface

Clean debris, dress, theatre to scrub

Question 13

What is degloving?

Answer 13

Skin and blood supply torn off

Question 14

What is an incision wound and what is it important to investigate for?

Answer 14

Caused by a sharp/penetrating object (I.e stab/slash)

Investigate for underlying damage (ATLS)

Question 15

What is a laceration and how is it treated?

Answer 15

Blunt force trauma, skin splitting

Irrigate, clean and close with staples or sutures

Question 16

What is a risk from animal or human bites? How are they treated?

Answer 16

Infection

Possibly antibiotics, tetanus, vaccines

Irrigation, delayed closure

Question 17

What would the initial management of a patient with haemorrhagic shock be?

Answer 17

ATLS- advanced trauma life support

Airway - check airway with C spine control 
Breathing - breathing with oxygenation 
Circulation - with haemorrhage control 
Disability
Exposure