Shock

Question 1

What is shock?

Answer 1

Shock is present when the blood pressure or circulating blood volume is reduced to a level where tissue oxygenation is inadequate, leading to cellular hypoxia and irreversible tissue injury.

Question 2

What are the different categories/classifications of shock?

Answer 2

Vasodilatory: Anaphylaxis, Neurogenic, Septic: inflammatory mediators > SIRS > Vasodilation and increased vascular permeability

Cardiogenic: Myocardial damage, Arrhythmias, Extrinsic compression (Pericardial disease), Outflow obstruction

Hypovolaemic

Question 3

For hypovolaemia shock, what is the prime problem, compensation and consequence?
Clinical symptoms: Cold, clammy peripheries, Tachycardia, Prolonged cap refill time, Empty Veins

Answer 3

Prime problem: inadequate volume, fall in CO
Compensation: inc resistance, tachycardia, CO falls
Consequence: hypotension

Question 4

For pump failure shock, what is the clinical symptoms, prime problem and further problems?

Answer 4

Clinical symp: Cold, clammy peripheries, tachy, inc cap refill, inc JVP, peripheral oedema, hepatomegaly. bi-basal crackles
Prime prob: fall in CO
Compensation: Inc resistance, tachy
Further prob: Inc capacitance

Question 5

For vasodilation shock, what is the clinical symptoms, prime problem, compensation and consequence?

Answer 5

Clinical symp: Warm, dry peripheries, Tachy, Short cap refill time, BOUNDING pulse
Prime prob: vasodilation
Consequence: hyoptension
Compensation: tachy, inc CO