Shock

Question 1

What is shock?

Answer 1

A syndrome in which tissue perfusion is inadequate in meeting the tissues metabolic requirements

Question 2

What is hypovolaemic shock?

Answer 2

A fluid-depleted state caused by acute haemorrhage.

Will be volume depleted with reduced SVR and CO.

Question 3

What is cardiogenic shock?

Answer 3

Reduced CO due to reduced contractility/reduced heart rate.

Primarily due to ischaemia.

Question 4

What is obstructive shock?

Answer 4

Mechanical obstruction with otherwise normal CO and heart.

Can be due to PE or amniotic fluid embolism.

Question 5

What are causes of distributive shock?

Answer 5

Disruption of normal vascular autoregulation, and profound vasodilation.

Poor perfusion, with raised cardiac output.

Question 6

What is the sepsis 6 bundle?

Answer 6

Blood cultures
Urine output
Fluids
Antibiotics (prophylactically)
Lactate level
Oxygen

Remember ‘BUFALO’.

Question 7

How quickly should the sepsis 6 bundle be given?

Answer 7

Within 1 hour.

Question 8

What is a fluid challenge?

Answer 8

Rapid administration of fluid with assessment of response.

Give 300-500ml over 10-20mins.