Chapter 8 - Shock

Question 1

Most common cause of death is insufficient _____

Answer 1

EARLY resuscitation

Question 2

What is the fick principle (3 steps)

Answer 2

1. On-loading of O2 to RBC in the lung
2. Delivery of RBC to tissue cells
3. Off-loading of O2 from RBC to tissue cells

Question 3

Organ tolerance to ischemia - heart /brain/lung

Answer 3

4-6min

Question 4

Organ tolerance to ischemia - kidney/liver/GI tract

Answer 4

45-90 min

Question 5

Organ tolerance to ischemia - muscle/bone/skin

Answer 5

4-6h

Question 6

4 types of shock

Answer 6

Hypovolemic shock
Distributive shock
Obstructive shock
Cardiogenic shock

Question 7

Characteristic of distributive shock

Answer 7

Vascular container enlarges without proportional increase in fluid volume

Question 8

Can occur when a C/S injury damages the spinal cord above where the nerves of the sympathetic nervous system exit

Answer 8

Neurogenic - distributive shock

Question 9

What is a septic shock?

Answer 9

Exhibits vascular dilation

Question 10

Obstructive shock vs cardiogenic shock

Answer 10

obstructive is extrinsic of the heart
cardiogenic is intrinsic - intracardiac cause of cardiac pump failure

Question 11

name the 3 stages of shock

Answer 11

Pre-shock
Shock
End-organ dysfunction

Question 12

What is pre-shock

Answer 12

body’s compensatory mechanism are able to maintain some degree of tissue perfusion

Question 13

What is shock (decompensated)

Answer 13

body’s compensatory mechanisms fail to maintain tissue perfusion (BP falls)

Question 14

What is end-organ dysfunction

Answer 14

tissue and cellular damage is so massive that the organism dies even if perfusion is restored

Question 15

Is the 3rd stage of shock reversible?

Answer 15

IRREVERSIBLE - end-organ dysfunction

Question 16

Pulse
Skin
BP range
LOC
during compensated shock

Answer 16

increased, tachy
white, cool, moist
normal
unaltered

Question 17

Pulse
Skin
BP range
LOC
during decompensated shock

Answer 17

marked increased/tachy/can progress to brady
white cold waxy
decreased
altered from disoriented to coma

Question 18

First symptoms you would expect in shock recognition? (2)

Answer 18

increase respiratory rate
increase HR

Question 19

Second most common physiological response to the development of shock?

Answer 19

Peripheral vasoconstriction

Question 20

What is the type of shock where skin temp is warm/dry
skin color is pink
Bp drops
LOC lucid
Cap refill normal

Answer 20

Neurogenic shock

Question 21

Pre-hospital management of shock should focus on what

Answer 21

DELIVER ADEQUATE O2

Question 22

Trauma patients in shock should be transported ____ and ____ unless indicated otherwise

Answer 22

supine & neutral