Shock and extra notes Flashcards
Causes and outcomes of hypovolemic shock
Burns, dehydration, increase sweating and vomiting
What are the sequences of events of hypovolemic shock?
- Decrease in blood volume
- Decrease in venous return (less blood to the heart)
- Decrease in CO (amount of blood heart pumps/min)
- Decrease in tissue perfusion
What are the treatments for shock?
- secure airway
- assiste ventilation
- provide O2
- never give anything by mouth
- O2 blanket
- stop fluid loss and replace lost fluid
- control external bleeds
- monitor vitals
- anticipate vomit
- hospital
- reassure patient
Define psychogenic shock
Loss of sympathic control due to:
- fear
- emotional distress
- sudden rxn to NS
- temporary dilation
- decreased oxygen to the brain
- syncope
What are the signs of psychogenic shock?
Decrease in pulse and BP, cold skin, faint
TRUE OR FALSE: psychogenic shock is commonly self-correcting
TRUE
Define neurogenic shock
Loss of sympathetic outflow and autonomic functions (loss of blood vessel control = vasodilation and hypotension), rare and usually a response to SCI
What are signs and symptoms of neurogenic shock?
Body cardia, weak pulse, warm skin, priapism (erection), cervical injury, decrease in BP
Define spinal shock
Temporary loss of neurologic function and automatic tone below level of SCI, may last days to weeks, NO perfusion to tissue
Define septic shock
sepsis (response ton infection) with drops in BP and organ failure such as vasodilation
What are the steps that follow a source of infection?
- Bacteria in your blood
- Leaking blood vessel
- Organ dysfunction
Signs and treatment of septic shock
Cool clammy and molted skin, decrease in BP
Treatment: give oxygen and rush to the hospital
Define anaphylactic shock
A severe allergic reaction that is a medical emergency
What are the symptoms of anaphylactic shock?
- Redness
- Itchy, burning skin
- Hives
- Swelling of tongue
- Generalized edema
- Pain to constrict chest
- Weak pulse
- Etc.
When do we insert epinephrine?
When breathing problems appear due to anaphylactic shock
Aside epipen, what is another treatment for anaphylactic shock?
Anti-histamine (oral)
Define cariogenic shock
Inadequate function of the heart of failure of its pumping activity
What can cause cariogenic shock?
Direct bruise to the heart, heart attack and cardiac arrest
What are signs and symptoms of cariogenic shock?
Chest pain, irregular/weak pulse, cyanosis, decrease in BP, anxiety
Define respiratory shock
Failure of the lungs to transfer sufficient oxygen into the bloodstream, occurs with breathing emergencies or respiratory arrest
What are the signs, symptoms and treatments for respiratory shock?
Rapid, weak pulse, decrease in BP, cyanosis, cool/clammy
Treatments: secure airway, assist ventilation, immediate transportation
Which type of shock shows warm and dry skin?
Neurogenic shock
TRUE OR FALSE: Hypovolemic, neurogenic, septic and cariogenic all result in low BP
TRUE
TRUE OR FALSE: neurogenic shock allows your LOC to be altered
FALSE: it’s lucid
What are classic signs of wound infection?
- increase in pain around the wound
- excess puss coming out of the wound
- redness
- fever/flu-like symptoms
- increased odor form the wound
- warmth
- swelling/tenderness
What are the secondary signs of infections in wounds?
- delayed wound healing
- foul smell
- wound breakdown/enlargement
- increased draining from the wound
- discoloration of the wound (darker)
- increased fragility of the wound bed
What are the goals of wound care?
- Hemostasis
- Promote wound healing
- Reduce scar formation
- Reduce tissue loss
What are the general O2 administration guidelines?
- Normal SpO2 range 95-100%
- Problematic SpO2: <90%
- Do not start O2 therapy if >92% (ex. 93%)
- Stop O2 therapy no higher than 96% O2 sat
What is the ischemia tolerance for the brain, heart and lungs?
4-6 minutes
What is the ischemia tolerance for the muscles, skin and skeleton?
4-6 hours
What is the ischemia tolerance for the pancreas, intestines and kidneys?
45-90 minutes
Which epistaxis are the most common?
Anterior epistaxis
Which type of nose bleeds cans be severe and spontaneous?
Posterior epsitaxis
Why do bruises start as red?
They are rich in oxygen due to the newly pooled blood underneath the skin
Define shock
Insufficient return of blood flow to the heart, resulting in inadequate supply of oxygen to all organs and tissues of the body
What is the most common cause of shock?
Haemorrage
What is the safest approach when dealing with shock?
Assume it is hemorrage until proven otherwise
What are the three stages of shock?
- Compensated shock =minimal changes
- Decompensated shock = systems begin failing
- Irreversible shock = ischemia and death imminent
What are the 3 elements of blood pressure?
- Fluid
- Pump : collects and moves fluid foward
- Pipes: distributes
Compensation leads to what?
Vasodilation increase and blood does not fill the system entirely
What are the 2 things you need to limit when someone goes in shock?
- insufficient blood supply
2. The slowing down of the body processes
Define hypovolemic shock
Results from large scale loss of blood, as might follow acute hemorrage, dehydration, loss of fluid, plasma, RBC and electrolytes
