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Flashcards in Shock Deck (24):
1

Definition of Shock

Inadequate organ perfusion to meet the tissue's oxygenation demand

2

What qualifies as Hypotension

<60 or a decrease in 40 systolic

3

Acidosis

From the accumulation of acid when anaerobic metabolism occurs.

4

What happens during metabolic acidosis?

ATP production fails, the Na/K pump fails. Leads to cell swelling/rupture/death.

5

Systemic vascular resistance index

(MAP-CVP)/CI all times 80

6

Pulmonary vascular resistance index

MPAP - PAWP / ci * 80

7

When does anaerobic metabolism occur?

If oxygen demand is greater than oxygen consumption.

8

Signs of organ hypoperfusion

Mental status changes, oliguria, lactic acidosis

9

4 Categories of shock

Cardiogenic, hypovolemic, obstructive, distributive

10

Goals of shock resuscitation

Restore blood pressure, normalize perfusion, preserve organ function

11

Hypovolemic shock

Occurs from low blood volume. From trauma/hemorrhage, diarrhea, dehydration, burns!

12

Signs of hypovolemic shock

Decreased CO, decreased PAWP, increased SVR

13

Treatment of hypovolemic shock?

Reverse hypovolemia with crystalloid/colloid. Control hemorrhage. Maybe give pressor agents.

14

Crystalloid vs colloid

Crystalloids are cheaper. Blood must supplement either. No survival benefit with colloids.

15

Cardiogenic shock

Defect in cardiac function

16

Signs of cardiogenic shock

Decreased CO, increase PAOP, increase SVR, decrease LVSW

17

Coronary perfusion pressure

= DBP -PAWP.

18

What is the goal coronary perfusion pressure

>50mmHg

19

How to treat cardiogenic shock

Fluids first, cautious pressors. Give inotropes too.

20

Distributive shock

Sepsis, anaphylaxis, acute adrenal insufficiency, neurogenic

21

Signs of distributive shock

Generally decreased SVR. Not sure about CO or PAOP

22

Systemic inflammatory response syndrome treatment

Prompt volume replacement, give antibiotic, give inotropes (Da first). If really low map, give DA and then NE

23

Obstructive shock

Tamponade, tension pneumothorax, massive PE.

24

Signs of obstructive shock.

Decreased Co, Increase PCOP, Increased SVR