Shock and haemorrhage

Question 1

Causes

Answer 1

Hypovolaemia
Cardiogenic
Obstructive
Vasodilatory (/hypovolaemia)

Shifting up and to left –> improved contractility for same degree of filling –> inotropic and sympathetic stimulation

Question 2

Hypovolaemia

Answer 2

Trauma and infection increase capillary permeability with local sequestration of fluid and oedema

Question 3

Neurogenic shock

Answer 3

Spinal transection leads to loss of sympathetic outlflow below level –> vasodilation

Rapid increase in bed and capacitance –> reduced venison return dn reduced CO

Often relative bradycardia

Sometimes epidural does something similar

Question 4

Sepsis

Answer 4

Early
Restlessness and slight confusion
Tachypnoea and tachycardia
Vasodilation
High CO
Normal or slightly decreased BP
Oliguria
Metabolic acidosis, elevated blood lactate
Warm, dry suffused extremities

Late
Decreased ALOC
Tachypnoea and tachycardia
Low CO
<80 sys
Oliguria
Met acidosis, elevated lactate
Cold extremities

10mL/kg if norm, 20mL/kg if hypotensive

High flow oxygen