shock treatment Flashcards
what is the goal of shock treatment
restoration of oxygen delivery to the tissues
what are the clinical signs of dyspnea and hypoxia
cyanosis, tachycardia, tachypnea, melena, anxiety
what does oxygen therapy depend on
duration, demeanor of patient, equipment avail.
what are the methods of O2 admin
FiO2, flow by oxygen, face mask, oxygen hood/cage, nasal oxygen cannula/ catheter
what is the fluid therapy for shock syndrome
most effective way to improve O2 deliver - increased CO2 by optimizing vascular volume
what are the main 3 types of IV fluids for shock resuscitations
isotonic cystalloids, hypertonic saline, synthetic colloids
what should we know about isotonic crystalloids
fluid with electrolyte concentration and osmolality similar to that of plasma (0.9 NaCl, LRS, PLA 148, Normosal), rapid expanding intravascular volume
what are the benefits of isotonic cystalloids
inexpensive, long track record of success, ability of redistribution
what are the advert effects of isotonic fluids
rate of infusion, predisposition of fluid overload
what should we know about hypertonic crystalloids
cases fluid shift from intracellular and interstitial space into the intravascular space
what are the benefits of hypertonic crystalloids
when limited support is avail (small vol needed)
possible positive inotropic
immediate effects
decreases intracranial pressure
what are the adverse effects of hypertonic crystalloids
hypernatremia, hyperchloremia, metabolic acidosis, vasodilation and cardiovascular collapse
which patients should we not use hypertonic crystalloids in
dehydrated patients
what are the medications used for shock treatment
analgesia, sedation, antibiotics, cardiac meds (diuretics, positive inotropic, anti-arrhythmic, GI protectants
what patients are recommended for synthetic colloids
hypoproteinemic patients, ones that unable to tolerate large volumes of fluid, give in conjunction with crystalloid
