Shock Flashcards
1
Q
What are the four general types of shock?
A
hypovolemic
cardiogenic
distributive
obstructive
2
Q
What are some causes of cardiogenic shock?
A
ACS
valve failure
dysrhythmias
3
Q
What are some causes of distributive shock?
A
sepsis
anaphylaxis
neurogenic
4
Q
What are some causes of obstructive shock?
A
PE
tension pneumo
tamponade
5
Q
What labs should you get for shock evaluation?
A
CBC and coags lytes BUN/creatinine UA LFTs CXR, EKG Lactate UPT VBG/ABG cultures cardiac enzymes
CT or VQ scan if PE, echo if tamponade
6
Q
For cardiogenic shock: HR? CVP? Contractility? SVR?
A
HR up (reflex) CVP up (byproduct) contractility down (main issue) SVR up (reflex)
7
Q
FOr hypovolemic shock: HR? CVP? Contractility? SVR?
A
HR up (reflex) CVP down (byproduct) Contractility may be up or normal SVR up (reflex)
8
Q
For distributive shock: HR? CVP? Contractility? SVR?
A
HR up (reflex) CVP way down (byproduct) Contractlility varies SVR down (main issue)
9
Q
For obstructive shock: HR? CVP? Contractility? SVR?
A
HR up (reflex) CVP nl or up Contractility varies SVR is up if tamponade or PE but down in tension PTX
10
Q
Describe general management of shock.
A
ABCs
intubate for airway protection, oxygenation or fatigue
two large bore IVs or a central venous catheter
in most cases, crystalloid fluids given as boluses (but be careful in cardiogenic shock with pulmonary edema)
blood if hemorrhagic
vasopressors if they don’t respond to fluids (epi, norepi, dopamine, vasopressin)
