Shock--Adams Flashcards
1st step for Tx of all shock types
fluids, fluids, fluids
normal saline
What are the 4 types of shock
cardiogenic
extracardiac
disruptive/dissociative
neurogenic
What is a common finding in most shock types?
hypotension
Why might a shocky patient not be tachy?
beta-blocker use
(very common)
Common lab findings of shock
(disruption of normal cellular gradients due to loss of Na+/K+ ATPase)
hyponatremia
hyperkalemia
lactic acidosis
metabolic acidosis
hyperglycemia
Two stages of shock
systemic inflammatory response syndrome
muli-organ dysfunction syndrome
Systemic inflammatory response syndrome
septic shock-like disorder that can progress to
multi-organ system dysfunction syndrome
Multi-organ dysfunction syndrome
how to diagnose
labs
Shock
classical findings
cool, clammy skin
hypotension
altered mental status
metabolic acidosis
When do you not get cool, clammy skin during shock?
during disruptive/dissociative shock
such as during pre-eclampsia
Basic monitoring of shocky patient
mental status
renal function (urine output)
organs most sensitive to ischemia
Shock index
heart rate/systolic
>1 is bad
Examples of disruptive/dissociative cardiogenic shock
septic shock
anaphylaxis
Examples of extracardiac shock
PE
cardiac tampanade
2 basic Tx for shocky patients
fluids
vasopressors (epi, NE, dopamine, dobutamine)
