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Assessment of shock Flashcards

(49 cards)

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1
Q

Define stroke volume

A

volume of blood ejected from left ventricle

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2
Q

Define systemic vascular resistance

A

resistance to BF offered by systemic vasculature (determined by diameter)

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3
Q

Differentiate shock from dehydration

A
  • Intravascular - shock

- Interstitial - dehydration

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4
Q

CS - dehydratio

A
  • tacky MM
  • skin tent
  • dry tear film / sunken eyes
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5
Q

CS - shock

A

6 perfusion parameters:

  • HR
  • pulse quality
  • MM colour
  • CRT
  • extremity / body temperature
  • mentation
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6
Q

Normal HR range - cats

A

160-200bpm

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7
Q

Why do you see tachycardia in shock?

A

compensation

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8
Q

What happens to HR when shock lasts a long time?

A

bradycardia - this is decompensated shock

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9
Q

Other ddx - tachycardia

A
  • shock
  • hypoxaemia
  • anaemia
  • pain
  • tachyarrythmia
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10
Q

Other ddx - bradycardia

A
  • bradyarrhythmia
  • increased ICP
  • shock
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11
Q

Define pulse quality

A

difference b/w systolic and diastolic BP

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12
Q

Where to measure pulse quality?

A

femoral and metatarsal pulse

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13
Q

How does pulse quality change in shock?

A

increased or decreased - depends on the type of shock

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14
Q

T/F: sometimes pulse quality is not the same as blood pressur

A

True

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15
Q

MM colour - shocked patients

A

pale or injected

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16
Q

Ddx - pale MM

A

shock, anaemia, hypoxaemia

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17
Q

Ddx - injected MM

A

shock, gingivitis

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18
Q

Where to take CRT on gingivitis patients?

A

Mucosa of lip as gingivitis can affect CRT

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19
Q

How can temperature indicate shock?

A
  • decreased extremity: mild to moderate shock

- decreased body temperature: common in cats, severe shock in dogs

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20
Q

Mentation with shock

Study These Flashcards
A
  • obtunded
  • stuporous (non-responsive except painful sitmuli)
  • comatosed (non-responsive even with painful stimuli)
21
Q

Why is shock life-threatening?

Study These Flashcards
A

cardiac arrest

22
Q

What are the 4 types of shock?

Study These Flashcards
A
  • hypovolaemaic
  • vasodilatory
  • obstructive
  • cardiogenic
23
Q

Colour of patients with the different types of shock

Study These Flashcards
A
  • vasodilatory: injected

- hypovolaemic, obstructive and cardiogenic: pale

24
Q

Why might you have decreased preload?

Study These Flashcards
A

hypovolaemic or obstructive shock

25
Why might you have reduced cardiac contractility?
cardiogenic shock
26
Why might you have reduced HR and rhythm?
cardiogenic shock
27
How are the 6 signs of shock categorised?
mild, moderate, decompensated
28
How do we differentiate b/w the 3 types of vasoconstrictive shock
hx PE other diagnostic tools
29
What are the 3 types of vasoconstrictive shock?
hypovolaemic obstructive cardiogenic
30
CS- hypovolaemic shock
- dehydration - V/D - haemorrhage - 3rd space loss - PU
31
Tx - hypovolaemic shock
- IVFT | - tx underlying cause (e.g. haemorrhage)
32
Examples of causes of obstructive shock
- GDV - pericardial effusion - pneumothorax
33
PE - obstructive shock
- distended abdomen - decreased heart sounds - decreased lung sounds
34
Dx tools - obstructive shock
- radiographs | - ultrasound of chest
35
Tx - obstructive shock
- relieve obstruction | +/- IVFT
36
PE - cardiogenic shock
- asucultate heart and lugns | - jugular distension
37
Tools - cardiogenic shock
- ECG | - echocardiogram: La:Ao (enlarged >1.5) contractility, pericardial effusion
38
Tx - cardiogenic shock
- NOT FLUIDS!!! - anti-arrhythmics - positive inotropes
39
Name 3 ventricular arrythmias
- VPCs - accelerated idioventricular rhythm - ventricular tachycardia
40
When can ventricular arrhythmias occur in shock?
any of the 4 types of shock: challenging as may require fluids depending on the cause
41
Examples of vasodilatory shock
- systemic inflammatory response syndrome (SIRS) - sepsis - anaphylaxis - anaesthesia
42
Tx -vasodilatory shock
- IVF | - vasopressors to improve systemic vascular resistance
43
Name 2 other markers of shock
- lactate | - BP
44
How is lactate a marker of shock?
- normal
45
Outline BP in shock
- mild-moderate may be normal - normal systolic 90-160mmHg - normal mean BP 60-120mmHg
46
Is it possible to have more than one type of shock?
Yes
47
What affects stroke volume?
preload, afterload and contractilit
48
Outline the 6 signs of vasoconstrictive shock related to the category (mild, moderate, decompensated)
- HR: mild - increased, moderated - more increased, decompensated - decreased (n.b. cats may have increased or decreased rate at any stage) - PULSE QUALITY: mild - increased/decreased, moderate - quite decreased, decompensated - severely decreased - MM COLOUR: mild - pale pink, moderate - pale, decompensated - very pale - CRT: mild - 1.5-2, moderate 2-3, severe >3 - EXTREMITY/BODY TEMPERATURE: mild - decreased, moderate - quite decreased (cats decreased BT), decompensated - decreased BT - MENTATION: mild - mild obtundation, moderate - moderate obtundation, decompensated - stuporous
49
Outline the 6 signs of vasoDILATORY shock in relation to the categories (mild, moderate, decompensated)
- HR: mild - increased, moderate - quite increased, decompensated - decreased (cats can have increased or decreased at any stage) - PULSE QUALITY: mild - increased, moderate - increased (cats decreased) decompensated - increased/decreased (cats decreased) - MM COLOUR: mild - injected, moderate - injected, cats pale, decompensated - injected, cats pale - CRT: mild 2s - EXTREMITY/BODY TEMPERATURE: mild - increased, moderate - increased, decompensated - increased/decreased - MENTATION: mild - mild obtundation, moderate - moderate obtundation, decompensasted - stuporous

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