Chapter 15 - Shock and Resuscitation Flashcards Preview

EMT - Basic - Prehostpital Emergency Care 10th Edition > Chapter 15 - Shock and Resuscitation > Flashcards

Flashcards in Chapter 15 - Shock and Resuscitation Deck (78):
1

a critical condition that results in the inadequate perfusion of cells, tissue, and organs.

shock

2

the ability or tendency to maintain internal stability in an organism to compensate for environmental changes.

homeostasis

3

inadequate amounts of oxygen and glucose delivered to cells

hypoperfusion

4

an acute type of pericardial effusion in which fluid, pus, blood, clots, or gas accumulates in the pericardium (the sac in which the heart is enclosed), resulting in slow or rapid compression of the heart.

pericardial tamponade

5

shock that is caused by a low volume of blood or fluid

hypovolemic

6

an escape of blood from a ruptured blood vessel, especially when profuse.

hemorrhage

7

forms of hypovolemia that are associated with fluid loss from burns and dehydration

nonhemorrhage

8

the state or quality of a material or membrane that causes it to allow liquids or gases to pass through it

permeability

9

shock state caused by a reduction in systemic and peripheral vascular resisance

distributive shock

10

shock caused by ineffective pump function of the heart

cardiogenic shock

11

shock that results from a condition that obstructs forward blood flow

obstructive shock

12

sudden blockage in a lung artery, also called: Blood clots in the lung

pulmonary embolism

13

type of shock described as a dysfunction in the ability of oxygen to diffuse into the blood, be carried by hemoglobin, off-load at the cell, or be used effectively by the cell for metabolism

metabolic shock or respiratory shock

14

shock that results from the loss of whole blood from the intravascular space

hemorrhagic hypovolemic shock

15

shock caused by loss of fluid from the intravascular space; however, red blood cells and hemoglobin remain within the vessels.

nonhemorrhagic hypovolemic shock

16

medication of choice in the anaphylactic shock patient. __________ contains alpha properties that cause systemic vasoconstriction

epinephrine

17

emergency care for anaphylactic shock

airway management, ventilation, and oxygenation - epinephrine

18

emergency care for hemorrhagic hypovolemic shock

stopping the bleeding is the first step in management of this patient. often requires administration of whole blood or blood components to replace intravascular blood volume that was lost

19

emergency care for nonhemorrhagic hypovolemic shock

administration of intravenous fluids - ALS

20

emergency care for burn shock

establish and maintain adequate airway, ventilation, and oxygenation. also, prevent further contamination of the burn injury.

21

type of distributive shock. it results from an infection that releases bacteria or toxins in the blood, causing the vessels throughout the body to dilate and become permeable

septic shock

22

emergency care for septic shock

manage the airway, ventilation, and oxygenation. benefit from intravenous fluids and medication to constrict the vessels - ALS

23

type of distributive shock - spinal cord injury.

neurogenic shock

24

emergency care for neurogenic shock

spinal immobilization and management of the airway, ventilation, and oxygenation. patient may benefit from intravenous fluids to fill the vascular space and medications to constrict the vessels. - ALS

25

emergency care for cardiogenic shock

manage the airway, ventilation, and oxygenation. patient may benefit from intervention and medications administered by ALS

26

the effects of the sympathetic stimulation, which occur immediately, are:

increase in heart rate
increase in force of ventricular contraction (stroke volume)
vasoconstriction
stimulation of the release of epinephrine and norepinephrine from the adrenal gland

27

stimulatory effect of alpha1

contraction of the muscles controlling the iris

contraction of vascular smooth muscle causing vasoconstriction

stimulation of sweat glands

28

stimulatory effect of beta1

increased heart rate

increased speed of impulse through conduction system

increased force of contraction

29

stimulatory effect of beta2

bronchial smooth muscle dilation

skeletal muscle contractility

30

sign or symptom of alpha1 stimulation

dilated pupils

pale cool skin, narrow pulse pressure

localized sweating, clammy skin

31

sign or symptom of beta1 stimulation

tachycardia

pounding heart

32

sign or symptom of beta 2 stimulation

decreased airway

tremors

33

In this stage of shock the body is compensating for blood loss. The signs and symptoms are limited and the human system functions normally.

compensated shock

34

epinephrine effect on body:

increased heart rate
increased contractility
vasoconstriction
sweat gland stimulation
decreased insulin secretion
conversion of non-carbohydrates into sugar
iris muscle constriction

35

epinephrine release sign or symptom:

tachycardia
pounding heart
pale cool skin
clammy skin
increased blood glucose level
pupillary dilation

36

norepinephrine effect on body:

vasoconstriction
sweat gland stimulation

37

norepinephrine release sign or symptom:

pale cool skin
clammy skin

38

antidiuretic hormone (vasopressin) effect on body:

increased sodium reabsorption in the kidneys
vasoconstriction

39

antidiuretic hormone (vasopressin) release sign or symptom:

decreased urine
increased blood pressure

40

angiotensin II effect on the body:

vasoconstriction
increased heart rate
sodium reabsorbtion in the kidney

41

angiotensin II release sign or symptom:

pale cool skin
tachycardia
decreased urine output

42

aldosteronen effect on the body:

sodium reabsorbtion in the kidney

43

aldosteronen release sign or symptom:

decreased urine output

44

glucagon effect on the body:

conversion of stored glucose in liver to blood glucose
conversion of noncarbohydrates into sugar
increased heart rate and contractility

45

glucagon release sign or symptom:

increased BGL
tachycardia

46

advanced stage of shock in which the body's compensatory mechanisms are no longer able to maintain a blood pressure and perfusion of the vital organs.

decompensated shock

47

a restriction in blood supply to tissues, causing a shortage of oxygen and glucose needed for cellular metabolism (to keep tissue alive).

ischemic
(I'ski:mic)

48

occurs when blood flow to your heart is reduced, preventing it from receiving enough oxygen. The reduced blood flow is usually the result of a partial or complete blockage of your heart's arteries (coronary arteries).

Myocardial ischemia

49

microemboli

small clots

50

fibrinolysis

substances that attempt to break up blood clots

51

signs of poor perfusion:

altered metal status
pale, cool, clammy, skin
delayed capillary refill
decreased urine output
weak or absent peripheral pulses

52

physical assessment indicators of hypovolemic shock - vital signs:

decreasing blood pressure
narrowing pulse pressure
tachycardia
tachypnea
pale, cool, clammy skin
unobtainable or poor SpO2 reading

53

physical assessment indicators of hypovolemic shock - signs of poor perfusion:

anxiety/decreased metal status
pale, cool clammy skin
delayed capillary refill
weak or absent peripheral pulses
decreased urine output

54

physical assessment indicators of cardiogenic shock - vital signs:

decreasing blood pressure
narrowing pulse pressure
tachycardia or bradycardia; may be irregular
tachypnea
pale, cool clammy skin; cyanotic or mottled skin
decreased Sp02 reading

55

physical assessment indicators of cardiogenic shock - signs of poor perfusion:

anxiety/decreased mental status
pale, cool clammy skin; cyanotic or mottled skin
jugular venous distention and peripheral edema (right-sided heart failure)
weak or absent peripheral pulses
decreased urine output
other sign: crackles or rales upon auscultation (left-sided heart failure)

56

physical assessment indicators of distributive shock - vital signs:

decreasing blood pressure

tachycardia (anaphylactic and septic shock)

relative braycardia or normal heart rate (neurogenic shock associated with a spinal cord injury)

tachypnea with respiratory distress and wheezing (anaphylactic shock)

normal respiratory rate (neurogenic)

warm, flushed skin (neurogenic)

warm, flushed skin with hives, possible cyanosis (anaphylactic)

mottled, cyanosos (late-sepsis, anyphylactic and neurogenic)

severely decreased Sp02 reading (anaphylactic)

57

physical assessment indicators of distributive shock - signs of poor perfusion:

anxiety/decreased mental status
mottled, cyanosis
weak or absent peripheral pulses
decreased urine output
other signs:
fever
loss of motor/sensory function
edema

58

occurs when the ventricles of the heart, for any of a variety of reasons, are not contracting or when the cardiac output is completely ineffective and no pulses can be felt

cardiac arrest

59

uncoordinated twitching in the heart

ventricular fibrillation

60

three phases a patient goes through following cardiac arrest that lead to biological death:

electrical phase
circulatory phase
metabolic phase

61

during this early and initial phase, the heart still has a good supply of oxygen and glucose; therefore, aerobic metabolism is maintained with continued energy production for cell function and prevention of mass production of acid.

electrical phase

62

during this phase, the oxygen stores have been exhausted and the myocardial cells shift from aerobic to anaerobic metabolism. this results in very little energy production for cell function, in addition to the production of acid.

circulatory phase

63

at this point the heart is starved of oxygen and glucose and has a large amount of acid buildup. the tissues are very ischemic and may begin to die. the chances of survival drop dramatically during this phase.

metabolic phase

64

______is from the time the patient goes into cardiac arrest until CPR is effectively being performed.

downtime

65

_______is the total time from when the patient went into cardiac arrest until you delivered the patient to the emergency department.

total downtime

66

________is when the patient regains a spontaneous pulse during the resuscitation effort. the patient may not yet have begun to breathe on his own; however, if the pulse returns spontaneously it is considered a ROSC.

return of spontaneous circulation

67

______ is when the EMT witnessed the patient become unresponsive, apneic, and pulseless. it does not refer to a layperson watching the patient collapse

witnessed cardiac arrest

68

______is when the emt arrives on the scene and the patient is already unresponsive, apneic, and pulseless.

unwitnessed cardiac arrest

69

adult chain of survival:

immediate recognition and activation
early CPR
rapid defibrillation
effective advanced life support
integrated post-cardiac-arrest care

70

pediatric chain of survival:

prevention of arrest
early high-quality CPR performed by bystanders
rapid activation of EMS or other emergency medical responders
effective advanced life support and rapid transport to an appropriate medical facility
integrated post-cardiac-arrest care

71

the procedure of sending an electrical current through the chest, is necessary to convert an abnormal and lethal rhythm with no pulse to an organized rhythm capable of producing a pulse.

defibrillation

72

VF SCA

ventricular-fibrillation-induced sudden cardiac arrest

73

disorganized cardiac rhythm that produces no pulse or cardiac output.

ventricular fibrillation (VF or V-Fib)

74

very fast heart rhythm that is generated in the ventricle of the sinoatrial node in the atrium. because the pumping is so rapid, the heart does not refill properly and cardiac output is sharply reduced.

ventricular tachycardia (VT or V-Tach)

75

_____is the absence of electrical reactivity and pumping action in the heart.

asystole "flatline"

76

heart has an organized rhythm, but either the heart muscle is so weakened that it fails to pump, or the heart muscle does not respond to the electrical activity, or the circulatory system has lost so much blood that there is nothing to pump

pulseless electrical activity

77

These devices, powered by long-life batteries, are placed under the skin and have tiny electrodes connecting to the heart. Whenever the patient's heart rate moves outside a certain range, the device takes over the task of setting the hearts pace.

Cardiac pacemakers

78

These devices are surgically implanted and used in cases of ventricular heart rhythm disturbances that cannot be controlled by medication.

Automatic implantable cardioverter defibrillators

Decks in EMT - Basic - Prehostpital Emergency Care 10th Edition Class (44):