Shock

Question 1

define shock

Answer 1

Failure to deliver oxygen & nutrients to meet the metabolic demands of tissues. which results in Failure to remove metabolic end products and then eventually cellular dysfunction and eventual organ failure.

Question 2

3 phases of shock recognition

Answer 2

1. Compensated
2. Decompensated
3. Irreversible

Question 3

Compensated phase of shock

Answer 3

• Normal BP
• Tachycardia
• Redistribution of
  blood to key
  organs
• Delayed capillary
  refill time
• Decreased urine
  output

Question 4

Decompensated phase of Shock

Answer 4

• Hypotension
• Anaerobic energy
  production of
  tissues
• Worsening
  metabolic acidosis
• Renal failure &
  oedema
• Decreased response
  to inotropes

Question 5

Irreversible phase of shock recognition

Answer 5

• Multiorgan
  dysfunction
• Intractable
  metabolic acidosis
• Poor response to
  inotropes
• Death

Question 6

Types of shock

Answer 6

D NACHOS

1. Distributive
   2.Neurogenic
   3.Anaphylactic
   4.Cardiogenic
   5.Hypovolemic
   6.Obstructive
   7.Septic

Question 7

Distributive Shock

Answer 7

Results from excessive vasodilation and the impaired distribution of blood flow.

Some tissues inadequately perfused

Some tissues overly perfused

Question 8

causes of a distributive shock

Answer 8

• Septic Shock
• Anaphylactic Shock
• Neurogenic Shock

Question 9

Neurogenic shock

Answer 9

Where damage to the patients nervous system
prevents them from stabilising heart rate, blood pressure and temperature.

Question 10

Causes of neurogenic shock

Answer 10

• Central Nervous System damage
• Damaged Brain
• Damaged Spinal Chord

Question 10

Anaphylactic Shock

Answer 10

Occurs when the patient has a severe allergic reaction to an allergen which causes their immune system to overreact and release histamine

Question 11

Causes of an anaphylactic shock

Answer 11

Allergen enters; orally, intravenously, inhaled or through skin

IgE Anitbody responds and sends Mast Cells
and Basophils who release Histamine

Causing vasodilation and leak of fluids from tissue to interstitial space – causing visible oedema, swelling of airways and hypotension

Question 12

Septic Shock

Answer 12

Sepsis is a pro-inflammatory cascade that is
triggered by and infection that can rapidly lead
to shock, organ dysfunction and death.

Question 13

Obstructive Shock

Answer 13

With obstructive shock there is something stopping blood going in and out of your heart or great vessels (superior vena cava, inferior vena cava and pulmonary vessels).

Question 14

Causes of Obstructive Shock

Answer 14

• Blockage of pulmonary vascular system (Pulmonary embolism, pulmonary hypertension)
• Extrinsic mechanical compression
  (tension pneumothorax, tamponade, restrictive cardiomyopathy)

Question 15

Cardiogenic Shock

Answer 15

The inability of the heart to create sufficient cardiac output to meet the demand for end organ oxygenation/perfusion due to cardiac pump failure.

Question 16

Hypovolemic Shock

Answer 16

Occurs when there is a large loss in intravascular blood volume, due to severe bleeding or fluid loss. Causes can be vomiting, diarrhoea, bleeding or burns.

Question 17

Management of shock

Answer 17

Oxygen
Fluids – crystalloid / colloid
Dextrose if needed
Antibiotics if sepsis is suspected