Shock

Question 1

What is the capillary refill time in case of shock

Answer 1

> 3 sec

Question 2

What happens to body temperature in septic shock

Answer 2

hyperthermia or hypothermia

Question 3

What size of IV catheter will you use in an adult to treat shock

Answer 3

16 G ( large caliber)

Question 4

Fluid replacement in hemorrhagic shock

Answer 4

1. Insert 2 iv lines

2. Give RL or 0.9% Normal saline- replace 3 times the estimated loss

Question 5

How will you administer adrenaline in case of anaphylaxis

Answer 5

Use 1 ml syringe graduated in 0.01ml
<6 yrs- 0.15 ml
6-12 yrs- 0.30 ml
>12 yrs/ adults - 0.50 ml
Inject into anterolateral thigh

Question 6

Fluid replacement in anaphylactic shock

Answer 6

1. Adults - 1 Litre (at max rate)

2. Children- 20 ml/kg

Question 7

How many times can you give I.M epinephrine in anaphylactic shock

Answer 7

Upto 3 times ( at 5-15min intervals)

Question 8

If anaphylactic shock persists after 3 I.M injections of epinephrine what do you do?

Answer 8

Give I.V epinephrine using syringe pump
Dose- 1:10,000
Children- 0.1-1 microgram/kg/min
Adult- 0.05-0.5 microgram/kg/min

Question 9

If there is persistent bronchospasm in anaphylactic shock. upto how many puffs of inhaled salbutamol can you give?

Answer 9

10

Question 10

Dosage of dopamine in cardiogenic shock

Answer 10

3-10 microgram/kg/min

Question 11

When do you use digoxin in case of cardiogenic shock?

Answer 11

Only in case of SVT confirmed by ECG and only after correcting hypoxia

Question 12

How many drops of IV fluid make 1 ml in

a) adult infusion set
b) pediatric infusion set

Answer 12

a) 20

b) 60

Question 13

If there is no IV infusion pump how will you administer IV epinephrine

Answer 13

a) Dilute 10 amp of 1 mg epinephrine ( 10,000 microgram) in 1L of 5% glucose or NS to give 10 microgram/ml
Eg. In adult weighing 50 kg
0.1 microgram/kg/min= 5 microgram/min = 10 drops/min ( as 20 drops make 1ml)