Flashcards in Haemorrhage & Shock Deck (26):
What is meant by circulatory shock?
When the cardiovascular system is unable to provide adequate oxygen & nutrients for aerobic cellular respiration
What are the signs of shock?
Pale, cold, sweaty, mottled skin
Pulse is weak and rapid
Pulse pressure is reduced
Slow capillary refill
Urine output is reduced
What are they types of shock?
What is hypovolaemic shock?
Severe blood or fluid loss meaning the heart can't pump enough blood around the body
What causes hypovolaemic shock?
- acute GI bleed
- Peri/post operative
- Splenic rupture
There are 3 classes of shock: what are they & how are they defined?
CLASS I: MILD
Up to 15% blood loss
Pulse less than 100bpm
Resp rate 14-20
Urine = >30ml/hr
Mental state: mildly anxious
CLASS II: MODERATE
15-30% blood loss
Pulse above 100bpm
Resp rate 20-30
Urine = 20-30ml/hr
Mental state: anxious
30-40% blood loss
Pulse above 120
Resp rate 30-40
Urine = 5-15ml/hr
Mental state: confused
What is cardiogenic shock?
Inadequate tissue perfusion caused by cardiac dysfunction
What causes cardiogenic shock?
Anything that causes pump failure
What is distributive shock?
Abnormal distribution of blood flow in the smallest blood vessels results in inadequate supply of blood to the body's tissues and organs.
What are the 3 types of distributive shock?
How does sepsis cause shock?
Causes blood flow in capillaries to be low in some and high in others
Endothelial cells in vessels become less responsive to vasoconstrictors, and produce an excess of NO
Coagulation cascade is disrupted which leads to DIC
RBCs develop a tendency to clump together inhibiting blood flow through vessels
What is DIC?
Disseminated intravascular coagulation
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
How does anaphylaxis cause shock?
Massive histamine release causes systemic vascular dilatation, causing a huge drop in BP
What is neurogenic shock?
Injury to the CNS which causes loss of vascular tone, so blood flow is altered
What is cytotoxic shock?
Shock caused by poisoning, eg. with cyanide
How would you manage septic shock?
Take cultures before antibiotics if time
Give antibiotics ASAP
How would you manage anaphylactic shock?
Give adrenaline (epipen)
Secure airway, give oxygen
Give saline to get BP up
How would you manage cardiogenic shock?
Treat the cause
MI = revascularisation, thrombolysis
How would you treat hypovolaemic shock?
If haemorrhagic, give blood
What are other symptoms of anaphylactic shock?
Why does shock cause low BP?
Reduction in ventricular filling = fall in stroke volume & BP
Why does shock cause oliguria?
reduced renal perfusion, reduced glomerular filtration
What does ARDS stand for?
Acute respiratory distress syndrome
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
What are the clinical features of ARDS?
Bi-lateral fine inspiratory crackles