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Surgery I > Hemorrhage > Flashcards

Hemorrhage Flashcards

(49 cards)

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1
Q

What is shock?

A

Oxygen delivery to body is compromised

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2
Q

What happens with shock?

A

Body will compensate as long as possible

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3
Q

What is seen in as a compensatory reaction to shock?

A

tachycardia + tachypnea + peripheral vasoconstriction

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4
Q

Reason in Shock: Tachycardia

A

Increase oxygen delivery

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5
Q

Reason in Shock: Tachypnea

A

Increase oxygenation

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6
Q

Reason in Shock: Peripheral vasoconstriction

A

Maintain perfusion to vital organs

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7
Q

What is a major consequence of perfusion and hypoxia?

A

Mental depression

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8
Q

What are the four types of shock?

A

Hypovolemia
Cardiogenic
Distributive
Hypoxic

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9
Q

What is hypovolemic shock?

A

Inadequate circulating volume

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10
Q

What can cause hypovolemic shock?

A

Hemorrhage
– and –
Loss of fluids

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11
Q

What occurs pathophysiologically with hypovolemic shock?

A

Reduced venous return = decreased preload
= less CO
= less oxygen to tissues

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12
Q

What are the classes of hemorrhagic shock?

A

I to IV

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13
Q

In what class of hemorrhagic shock do you see change in BP?

A

III

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14
Q

Blood loss amount: Class I

A

up to 15%

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15
Q

Blood loss amount: Class II

A

15 to 30%

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16
Q

Blood loss amount: Class III

A

30 to 40 %

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17
Q

Blood loss amount: Class IV

A

> 40%

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18
Q

What is cardiogenic shock?

A

Primary problem in the heart

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19
Q

What are the two types of cardiogenic shock?

A

Diastolic
– and –
Systolic

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20
Q

What is diastolic failure?

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A

Heart has problems filling

21
Q

What is systolic failure?

Study These Flashcards
A

Heart has problems pumping

22
Q

What is distributive shock?

Study These Flashcards
A

problems regulating vascular tone

23
Q

What are the common causes of distributive shock?

Study These Flashcards
A

Sepsis + SIRS

24
Q

What are the least common causes of distributive shock?

Study These Flashcards
A

Anaphylactic reaction
Anesthesia
CNS damage

25
What is the result of distributive shock?
Not enough BV to fill vascular space | Relative hypovolemia results
26
What is hypoxic shock?
Adequate tissue perfusion but blood not carrying enough oxygen
27
What are common causes of hypoxic shock?
Anemia Hypoxemia Toxins Carbon monoxide poisonig
28
What two structures in the body sense shock?
Baroreceptors -- and -- Low pressure stretch receptors
29
Location: Baroreceptors?
Carotid sinus -- and -- Aortic arch
30
Location: Low pressure stretch receptors
Atria -- and -- Pulmonary arteries
31
What happens once the SNS system is activated?
Increase in HR = Increase CO Constrict arterioles = blood to vital organs Constrict large veins = effective vascular volume
32
What does the SNS activation do chemically?
Activates the neuroendocrince response | Release angiotensin + vasopressin
33
What are that three levels of hypovolemic shock?
compensatory early compensatory compensatory
34
When do you start seeing hypovolemic induced tachycardia?
early compensatory
35
What is a very reliable indicator that early compensatory response is occurring?
Tachycardia
36
At what heart rate do you stop worrying about shock and more about a heart problem?
HR greater than 240
37
Shock organ: Dog
Gut
38
Shock organ: Cat
Lungs
39
What is the normal lactate level in a dog or cat?
40
What is considered hyperlactatemia?
6.0 mmol/L
41
What two blood alterations are seen in hypovolemic shock?
Increased lactate -- and -- Metabolic acidosis
42
What is the most common cause of hyperlactatemia?
Inadequate oxygen (type A)
43
What organs metabolize lactate?
Liver + Kidneys
44
What is the initial goal of treatment in shock?
Stabilize airway + breathing + circulation + neurologic derangements
45
What are the three components of therapy?
optimize oxygen delivery aggressive support of organ function ID and treatment of underlying disease
46
What are the components to treatment of shock?
Oxygen | Fluids
47
What amount of oxygen is give in shock?
100 ml/kg/min = FiO2 of 40 to 60%
48
What is a shock bolus?
dose of fluids/blood products given | normally give 1/4 to 1/3 and reassess patient
49
When should NSAIDS be avoided in shock patients?
Hypoperfusion--- will arm kidney

Surgery I (17 decks)

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