SHOCK

Question 1

BASIC CARDIAC PHYSIOLOGY

volume of blood that is pumped by the heart per minute
-> amount of blood being supplied by the heart per minute

Answer 1

cardiac output

Question 2

an abnormality of the circulatory system that results in inadequate organ perfusion and tissue oxygenation

Answer 2

SHOCK

Question 3

BASIC CARDIAC PHYSIOLOGY

determined by preload, myocardial contractility, afterload
-> amount of blood being pumped out per heartbeat

Answer 3

stroke volume

Question 4

BASIC CARDIAC PHYSIOLOGY

initial amount of blood present in the right atrium
volume of venous blood return to the left and right sides of the heart

Answer 4

preload

Question 5

BASIC CARDIAC PHYSIOLOGY

is the pump that drives the system
if there will be an opposing resistance or force hindering the outflow of the blood from the heart

Answer 5

afterload

Question 6

BLOOD LOSS PATHOPHYSIOLOGY

progressive ______ of cutaneous, muscular, and visceral circulation to preserve blood flow to the kidneys, heart, and brain

Answer 6

vasoconstriction

Question 7

BLOOD LOSS PATHOPHYSIOLOGY

___________ is the earliest measurable circulatory sign of shock

Answer 7

tachycardia

Question 8

TYPES OF SHOCK
_________ is the most common cause of shock

Answer 8

hemorrhage

Question 9

TYPES OF SHOCK
HEMORRHAGIC SHOCK: CLASS

exemplified by the condition of an individual who has donated 1 unit of blood

compensatory mechanism will restore blood vol. within 24 hours, usually without the need of blood transfusion

Answer 9

Class 1 Hemorrhage
<15%

Question 10

TYPES OF SHOCK
HEMORRHAGIC SHOCK: CLASS

uncomplicated hemorrhage for which crystalloid fluid resuscitation is required

tachycardia, tachypnea, and decreased pulse pressure

Answer 10

Class 2 Hemorrhage
(15-30%)

Question 11

TYPES OF SHOCK
HEMORRHAGIC SHOCK: CLASS

complicated hemorrhagic state in which at least crystalloid infusion is required and most will need blood products to reverse shock state

Answer 11

Class 3 Hemorrhage
(>40%)

Question 12

NON-HEMORRHAGIC SHOCK

suspect a blunt cardiac injury when the mechanism of injury to the thorax involves rapid deceleration

myocardial dysfunction can be caused by blunt cardiac injury, cardiac tamponade, an air embolus or MI

Answer 12

cardiogenic shock

Question 13

NON-HEMORRHAGIC SHOCK

commonly seen in patients with penetrating thoracic injury

Beck’s triad

Answer 13

cardiac tamponade

Question 14

NON-HEMORRHAGIC SHOCK

can also present similar manifestations of cardiac tamponade - distended neck veins and hypotension

develops when air enters the pleural space but a flap valve mechanism prevents its escape

Answer 14

tension pneumothorax

Question 15

NON-HEMORRHAGIC SHOCK

brainstem injuries

cervical and upper thoracic spinal cord injuries can cause hypotension —> loss of sympathetic tone

Answer 15

neurogenic shock

Question 16

NON-HEMORRHAGIC SHOCK

occur when a patient’s arrival at the ED is delayed for several hours

patients with early septic shock can have a normal circulating volume, modest tachycardia, warm skin, near normal SBP and a wide pulse pressure

Answer 16

septic shock

Question 17

BLOOD REPLACEMENT

complete crossmatching process approximately 1 hour

if crossmatched blood is unavailable, type O PRBC are indicated for exsanguinating hemorrhage

Answer 17

crossmatched type specific, and type O blood

Question 18

NON-HEMORRHAGIC SHOCK

heat fluid to 39C before infusion

accomplished by storing crystalloids in a warmer or infusing them through intravenous fluid warmers

Answer 18

prevent hypothermia

Question 19

NON-HEMORRHAGIC SHOCK

> 10 of PRBC within the 1st 24 hours of admission or more than 4 units in 1 hour

Answer 19

Massive transfusion

Question 20

NON-HEMORRHAGIC SHOCK

consider collection of shed blood for AT in patients with massive hemothorax

blood generally has only low levels of coagulation factors so plasma and platelets may still be needed

Answer 20

Autotransfusion

Question 21

NON-HEMORRHAGIC SHOCK

severe injury and hemorrhage result in consumption of coagulation factors and early coagulopathy

Answer 21

COAGULOPATHY

Question 22

BLOOD PRODUCTS

contains all coagulation factors
lasts up to 1 yr. frozen

Answer 22

fresh frozen plasma

Question 23

BLOOD PRODUCTS

refrigerated up to 42 days
usually for HgB less than or equal 7 g/dL

Answer 23

Packed RBCs

Question 24

BLOOD PRODUCTS

precipitate of thawed FFP
high factor Factor VIII (antihemophilic factor) and fibrinogen

Answer 24

cryroprecipitate

Question 25

BLOOD PRODUCTS

must be agitated to prevent clumps
room temp up to 5 days

Answer 25

Platelets