Haemorrhage & Shock Flashcards Preview

Cardiovascular > Haemorrhage & Shock > Flashcards

Flashcards in Haemorrhage & Shock Deck (21):
1

What is meant by circulatory shock?

When the cardiovascular system is unable to provide adequate oxygen & nutrients for aerobic cellular respiration

2

What are the signs of shock?

Pale, cold, sweaty, mottled skin
Pulse is weak and rapid
Pulse pressure is reduced
Low BP
Slow capillary refill
Tachypnoea
Urine output is reduced
Confusion
Weakness
Collapse
Coma

3

What are they types of shock?

Hypovolaemic shock

Cardiogenic shock

Septic
Anaphylactic

Anaemic shock

Cytotoxic shock

4

What is hypovolaemic shock?

Severe blood or fluid loss meaning the heart can't pump enough blood around the body

5

What causes hypovolaemic shock?

Blood loss:
- acute GI bleed
- Peri/post operative
- Splenic rupture

Fluid loss:
- Dehydration
- Burns
- Pancreatitis

6

What is cardiogenic shock?

Inadequate tissue perfusion caused by cardiac pump failure

7

What causes cardiogenic shock?

MI
Arrhythmia: V fib, etc
PE
Tension pneumothorax: pressure on mediastinum = no venous return to heart
Anything that causes pump failure

8

How does sepsis cause shock?

Infection

Inflammatory response to bacteraemia
Histamine, NO, other inf mediators released
Affects small blood vessels
Vasodilation, leaky capillaries
Reduced blood volume

Coagulation cascade is disrupted which leads to DIC

9

What is DIC?

Disseminated intravascular coagulation

Bacteraemia or trauma causes inappropriate widespread activation of coagulation cascade, formation of loads of blood clots in small vessels

Leads to the compromise of blood flow to tissue and organs

Since clotting factors and platelets are used up by the clots you get bleeding as well

10

How does anaphylaxis cause shock?

Massive histamine release causes systemic vascular dilatation and leaky capillaries

Causing a hypovolaemia, hypotension

11

What is neurogenic shock?

Injury to the CNS which causes loss of vascular tone, so blood flow is altered
I.e spinal injury?

12

How would you manage septic shock?

BUFALO

Blood cultures
Urine output
Fluid resuscitation
Antibiotics
Lactate
Oxygen (HF, NRB mask)

13

How would you manage anaphylactic shock?

ABCDE

Give IM adrenaline (epipen)
Anti-histamine: chlorphenamine
Hydrocortisone

14

How would you treat hypovolaemic shock?

Give fluids

If haemorrhagic, give blood

15

What are other symptoms of anaphylactic shock?

Breathlessness
Wheeze
Rash
Erythema
Angio-oedema

16

Why does shock cause low BP?

Blood/fluid loss

Reduction in ventricular filling = fall in stroke volume + therefore BP

17

Why does shock cause oliguria?

Reduced renal perfusion, reduced glomerular filtration

18

What does ARDS stand for?

Acute respiratory distress syndrome

19

What is ARDS?

Widespread inflammation in the lungs triggered by trauma, sepsis, etc.

Inflammation causes alveolar capillary membrane injury

Leading to impaired gas exchange in the lungs, so the body does not get enough oxygen

20

What are the clinical features of ARDS?

Cyanosis
Tachypnoea
Tachycardia
Bi-lateral fine inspiratory crackles

21

There are 3 phases in ARDS. What are they?

Exudative phase: accumulation of excessive fluid, protein + inflammatory cells in lungs

Proliferative phase: connective tissue & other structural elements proliferate in response

Fibrotic phase: scarring