Shock Flashcards
Aetiological groups of shock?
Septic Haemorrhagic Neurogenic Cardiogenic Anaphylactic
What is sepsis defined as?
Infection + SIRS
What are the SIRS criteria? (4)
Two of: Body temp outside 36.0-38.0 HR greater than 90 RR greater than 20 WBC outside 4.0 - 12.0
What qualifies as severe sepsis?
Sepsis with organ failure
What qualifies as septic shock?
Hypotension not responsive to fluid resuscitation
What is the SEPSIS 6 bundle?
Give:
oxygen
antibiotics
fluid
Take:
urine (fluid balance)
blood cultures
blood lactate
What is the benefit of implementing sepsis 6?
If completed within 1st hour, 50% mortality reduction
Average blood volume in an adult?
7% body weight; e.g. in 70kg person this equates to 5L
Physiological response to increasing blood loss? (5)
Respiratory rate increases (1st sign) Pulse rate increases Blood pressure drops Urine output drops Patient becomes increasingly confused/lethargic
Volume of blood loss before blood pressure begins to drop?
1.5L -2.0L
What arterial pressure is required to generate a palpable femoral pulse?
at least 65mmHg
In patient suffering from trauma, what are the likely causes of shock? (5)
Haemorrhagic (most likely)
Tension pneumothorax, myocardial contusion, cardiac tamponade (cardiogenic)
Spinal cord injury (neurogenic)
Pathophysiology of neurogenic shock?
High-level spinal cord transection
Loss of peripheral vascular tone
Decreased preload and thus decreased cardiac output
What is Starlings law?
Decreased venous return (preload) results in decreased cardiac output
Immediate management of anaphylaxis? (3)
Call for help
Lie patient flat and raise legs
IM adrenaline
