Shock (Ngwenyama)

Question 1

Definition of shock?

Answer 1

Inadequate delivery of oxygen to your tissues

Question 2

What does oxygen delivery depend on?

Answer 2

Cardiac output (HR x SV)
and oxygen carrying capacity (Hb and ventilation)

Question 3

What is the difference between compensated shock and decompensated shock?

Answer 3

Compensated shock is normotensive but shows poor perfusion and tachycardia. Decompensated shock their is hypotension and early organ dysfunction.

Question 4

Compensatory shock cats vs. dogs?

Answer 4

cats: lethargic, bradycardic, hypothermic
dogs: tachycardia, tachypnea, pyrexia, red then pale mm, decreased crt

Question 5

Different types of shock?

Answer 5

Cardiogenic
Obstructive
Hypovolemic
Distributive

Question 6

Pathophys of cardiogenic shock?

Answer 6

sys/diastolic dysfunction (tachycardia, poor SV = poor CO)
then decreased perfusion (low BP, and venous return)
Pulmonary edema (increased pulmonary venous pressure)

Question 7

What is obstructive shock?

Answer 7

physical blockage to venous return (GDV, PTE, tension pneumothorax, cardiac tamponade)

Question 8

What is the immediate treatment for hypovolemic shock?

Answer 8

Isotonic crystalloids first, then if needed, PRBCs or whole blood

Question 9

What is the pathophys of hypovolemic shock?

Answer 9

Loss of blood or other body fluid (decreased vascular volume) -> Decreased venous return and stroke volume (decreased CO) -> Decreased perfusion

Question 10

Where does the shock dose amount come from?

Answer 10

Blood volume (dogs 90 ml/kg/day, cats 60 ml/kg/day)

Question 11

What is the “practical approach to shock”, what should you address first?

Answer 11

1. Heart rate and rhythm
2. Volume status
3. Contractility
4. Peripheral vasculature

Question 12

All shocks you treat with what dose of fluids (all except which shock)?

Answer 12

NOT cardiogenic shock

- start with 1/4 shock dose of iso crystalloids, the reassess patient and repeat until out of shock.

Question 13

Vasopressors are preferred first then fluids in which type of shock?

Answer 13

Distributive. (septic shock)