Week 3 Shock

Question 1

What are the different types of wounds?

Answer 1

Abrasion (dragging against irregular surface), Degloving (skin, blood supply torn off), Incised (sharp, penetrating trauma, slash, stab), Laceration (blunt force trauma, skin splitting, irregular edge and level of depth), Bites (foreign body contamination), Burns

Question 2

How do you treat abrasions?

Answer 2

Clean debris out of wound, irrigate with saline (sometimes need to be in operating theatre)

Question 3

How do you treat degloving?

Answer 3

FIxing hypovolemic shock.

Question 4

How do you treat lacerations?

Answer 4

Irrigation, closing wound with skin glue/ steristrips staples, sutures

Question 5

How do you treat bites?

Answer 5

Vaccines, antibiotics, irrigate, delay closure (depends on infection)

Question 6

Describe basic first aid.

Answer 6

Take preventive measures, elevate the area (lower arterial pressure), direct pressure, remote pressure, control bleeding, replace lost blood, check history of bleeding)

Question 7

Describe the bleeding types from slowest to most lost of blood.

Answer 7

Capillary (slow), Venous (constant), Arterial (uncontrolled)

Question 8

Define shock.

Answer 8

Clinical syndrome where tissue perfusion and hence oxygenation is inadequate to maintain normal metabolic function.

Question 9

List the different types of shock.

Answer 9

1. Hypovolemic (4 classes, reduced blood flow)
2. Cardiogenic (enough blood but failure to circulate to heart)
3. Septic (fluid gathers in tissues)
4. Neuro (loss of tension in vessels)
5. Anaphylactic (allergies)

Question 10

How do you manage a patient with hemorrhagic shock?

Answer 10

Airway (assuming C-spine injury)
Breathing with oxygenation
Circulation with hemorrhage control
Disability (what injury do they have?) 
Exposure (look for other injuries)

Question 11

Classify hemorrhagic shock.

Answer 11

Class 1: 750 mL blood loss (15%), Pulse <100, BP normal, pulse pressure normal/ increased, 14-20 respiratory rate, >30 mL per hr urine output, slightly anxious

Class 2: 750-1500 mL (15-30%), Pulse rate 100-120, Normal BP, Decreased pulse pressure, 20-30 per min respiratory rate. 20-30 urine output, mildly anxious

Class 3: 1500-2000 mL (30-40%), Pulse rate 120-140, Decreased BP, Decreased pulse pressure, 30-40 breaths per minute, 5-15 urine output, anxious and confused

Class 4: >2000 (>40%), >140 pulse rate, decreased BP, decreased pulse prpessure, >35 breaths per min, urine output (negligible), confused, lethargic (not responsive)

Question 12

Outline the physiological changes in shock.

Answer 12

The greater the degree of shock, the more blood loss, the faster the heart rate and respiratory rate, the lower the BP and organ function.