Shock, Haemorrhage + Wounds Flashcards
(42 cards)
shock definition
a life-threatening, generalised form of acute circulatory failure with inadequate oxygen delivery and utilisation by cells
- decreased blood perfusion in tissues
shock clinical parameters
cardiovascular status - HR (goes up the greater the degree of shock) (BP may be maintained until later on, when it drops)
respiratory rate (RR)
GCS - Glasgow coma scale
biochemical markers, lactate, urine output
SOFA score (sequential organ failure assessment)
- organ function decreases
elderly tend to have less physiological reserve
medications may affect it
fever, chest pain, abdominal pain, bleeding..
types of shock
distributive, hypovolaemic, obstructive, cardiogenic
distributive shock
failure of vasoregulation, severe peripheral vasodilation
-sepsis - toxic effect to an inflammatory response
anaphylaxis - massice release of biochemical mediator
neurogenic - spinal cord injury causes vagal tone problems (measure of the PNS control over heart rate)
Hypovolaemic shock
loss of intravascular volume
haemorrhage - trauma, GI bleeding
non-haemorrhage - burns, DKA (diabetic ketoacidosis)
obstructive shock
barriers to cardiac flow or filling
pulmonary embolism, cardiac tamponade, tension pneumothorax (air building pressure in thorax)
cardiogenic shock
pump failure
myocardial infarction
treating distributive shock
fluid, vasopressors (target peripheral vasodilation)
antibiotics
treating hypovolaemic shock
fluid, blood
stop losses
treating cardiogenic shock
balance - vasopressors, inotropes (medication used to stimulate vasoconstriction or increase cardiac contractivity, fluids
cardiologist
cardiac output equation
CO = HR x SV
what happens in blood loss
intravascular volume loss
decreased cardiac output
impaired tissue oxygenation
affects organ function
ALL COMPONENTS LOST EQUALLY
function of blood
oxygen transport
clotting
healing + infection
transport system (nutrients + waste)
homeostasis
Emergency treatment - ATLS
Catastrophic haemorrhage control
Airway w/ c-spine control
Breathing w/ oxygenation
Circulation with haemorrhage control
Disability
Exposure
- emergency imaging
- secondary survey
airway obstruction treatments
adjuncts
intubation - different types
types of haemorrhage
abrasion, laceration, incised, degloving, bites
abrasions
superficial (epidermal skin loss)
not much bleeding if any
treatment of abrasions
clean + dress
laceration
blunt force trauma
skin splitting, tissue breaking, irregular edges/ levels/ depth
treatment of lacerations
close: glue, steristrips, staples, sutures
incised
sharp or penetrating trauma (e.g. slash/ stab wounds)
treatment for incised
clean edges, uniform shape
beware of depth
investigate for underlying damage
degloving
skin and its blood supply are torn off
major trauma
often with limbs/ digits
more severe injuries
bites
usually small entry wounds
possibly deep penetration
foreign body contamination
animals?
human blood borne viruses
cat bites are worse than dog bites for infections
