T1 - Shock (Josh)

Question 1

Define Shock:

Answer 1

Widespread abnormal cellular metabolism

Oxygenation and Tissue perfusion needs not met

Whole body response

Any problem impairing O2 delivery to tissues and organs can start shock, lead to life-threatening emergency

Question 2

Stages of Shock:

What happens in Initial Stage?

Answer 2

MAP drops 10 mmHg from baseline

Effective compensation (slight vasoconstriction

Increased HR, RR

O2 gets to vital organs

Question 3

Stages of Shock:

What happens in Nonprogressive (Compensatory) Stage?

Answer 3

MAP drops 10 - 15 mmHg from baseline

Kidney and Hormonal adaptive mechanisms activated

Tissue Hypoxia in NONVITAL organs (ex: gut)

Acidosis (drop in pH) and Hyperkalemia

Question 4

Stages of Shock:

What happens in the Progressive (Intermediate) Stage?

Answer 4

MAP drops 20 mmHg from baseline

VITAL organs develop hypoxia

Emergency

***conditions causing shock must be corrected within 1 HOUR of progressive stage onset

Question 5

Stages of Shock:

What happens in the Refractory (Irreversible) Stage?

Answer 5

Excessive Cell and Organ damage

Multi-system Organ failure

Decrease in pH

DEATH

Question 6

What are the different classifications of shock?

Answer 6

Hypovolemic

Cardiogenic (direct pump failure)

Distributive

Obstructive (indirect pump failure)

Question 7

What are some causes of Hypovolemic Shock?

Answer 7

Hemorrhage

Dehydration

Question 8

What are some causes of Cardiogenic Shock?

Answer 8

MI

Cardiac Arrest

Dyshythmia

Question 9

What are some causes of Distributive Shock?

Answer 9

Neural induced

Chemical induced

Question 10

What are some causes of Obstructive Shock?

Answer 10

Pericarditis

Caridac Tamponade

Pulmonary Embolis

Question 11

Which type of Shock is Burn Shock?

Answer 11

a combo of Hypovolemic and Distributive

Question 12

What is the purpose of prescribing the following two meds?

• Milrinone
• Dobutamine

Answer 12

enhance contractility

Question 13

Slide 17

Answer 13

Slide 17