Urgence Flashcards

1
Q

Examen physique trouvailles choc cardiogenique

A
Fc- variable
TA- dim
TVC- augm
Ext/RTP- froides/augm
PAoP- augm
Dc- dim ++
SvO2- dim
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2
Q

Examen physique trouvailles choc hypovolemique

A
Fc- augm
TA- dim
TVc- dim
Ext/RTP- froides/augm
PaOp- dim
Dc- dim
SvO2- dim
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3
Q

Examen physique trouvailles choc obstructif

A
Fc- augm
TA- dim
TVC- augm
Ext/RTP- froides/augm
Paop- dim
Dc- variable
SvO2- dim
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4
Q

Examen physique trouvailles choc distributif

A
Fc- augm
TA- dim
TVC- dim
Ext-RTP- chaudes/augm
Paop- dim
Dc- dim
SvO2- variable
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5
Q

Causes de choc cardiogenique

A

1- myopathie: IM

2- trauma: contusion, myocardite, BCC, cardiotox

3- arrythmie: tachy ou brady

4- mecanique: Ivalve, hypertrophie, defaut septal, myopathie

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6
Q

Causes choc hypovolemique

A

1- hemorragie: trauma, GI, retroperitoneal, postop

2- Deshydratation: diarrhee, vo, polyurie

3- Dilatation veineuse: sepsis, anaphylaxie, drogues

4- 3e espace

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7
Q

Causes de choc obstructif

A

= augm post-charge
1- dim remplissage: obst Veine cave

2- augm Pintra-thoracique: pneumothorax, ventilation mecanique

3- dim compliance cardiaque: pericardite, tamponnade

4- dim contraction cardiaque: embolie pulmo, HTP aigue

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8
Q

Causes choc distributif

A

= dilatation art & veineuse (dim precharge)
1- infection: septis, SST

2- Anaphylaxie

3- Neuro: choc spinal

4- Endo: Crise addison, thyroid storm

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9
Q

Tx Choc

A

= EARLY GOAL DIRECTED THERAPY

1) ABC
2) Investigations
3) Catheter veineux central (swan)
4) Repletion liquidienne agressive
5) ATB

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10
Q

Investigations a faire si pt en choc

A
SOSOS
Signes vitaux
pOumons: RXP + gaz art
Sang: lactate, LDH, bili, plaquette, INR, creat
cOeur: monitoring ECG
Sonde urinaire
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11
Q

Ordre réplétion liquidienne dans tx choc

A

But = stabilité hemodyn
Tx 1ere intention: cristalloïde
-si insuff: colloïde
Tx 2e intention: si hypoTA persiste
-Vasopresseurs: NE puis Dopamine puis Vasopressine
-Cortisol
Tx 3e ligne: inotrope (dobutamine) + Prot C activé + Transfusion GR + Corticostéroïdes

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