Week 1: Sepsis, shock, disaster

Question 1

SIRS Criteria

Answer 1

Temp: 36-38
WBC: 4-12
HR: >90
RR: >20

Question 2

Hypovolemic shock

Answer 2

Decreased volume in the tank
Dec BP, Inc HR
1˚ = FLUID
2˚ = Pressors

Question 3

Distributive shock

Answer 3

Massive vasodilation
Sepsis/septic shock
Anaphylactic shock
Dec BP, Inc HR

Question 4

Septic shock treatment

Answer 4

Fluid
Antibiotics
Pressors
NO antihistamines

Question 5

Anaphylactic shock treatment

Answer 5

Epi
Steroids (lag time)
Antihistamines
Fluids and pressors

Question 6

Cardiogenic shock

Answer 6

Heart failure
Dec BP, Inc HR
Cold shock
Edema/extravasation
\+/- fluids
ß-agonist pressors (dobutamine, milrinone)

Question 7

Obstructive shock

Answer 7

PE, tamponade, PNX
Inc BP, Inc HR
Ride side dysfxn, JVD
Treat obstruction
\+/- pressors, inotropes

Question 8

Vasopressin

Answer 8

V1 and V2 agonist
Increased reactivity to sympathomimetics
V1: inc SVR, constriction
V2: inc volume/retention
Good for hypovolemic, distributive

Question 9

Inotropes

Answer 9

Dobutamine, milrinone
Good for cardio
Useful for obstructive

Question 10

Phases of disaster response

Answer 10

1. Activation
2. Implementation
3. Recovery

Question 11

Indications for intubation

Answer 11

1. Airway protection
2. Insufficient O2 exchange
3. Insufficient CO2 exhalation (ventilation)
4. Expected clinical course