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Flashcards in Shock Deck (30)
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1
Q

what is the definition of shock

A

ineffective delivery of oxygen to the tissue infective perfusion

2
Q

what is the goal with shock

A

to optimize oxygen delivery amount

3
Q

what are the 4 types of shock

A

hypovolemic, cardiogenic, obstructive, dstributive

4
Q

what is hypovolemic shock

A

inadequate circulating volume -> decreased perfusion

5
Q

what are common causes of hypovolemic shock

A

hemorrhage, v/d, third spacing loss

6
Q

what is cardiogenic shock

A

results from heart failure, exclude factors outside the heart (only the heart this deals with)
-pumping function is severely impaired -> circulatory failure

7
Q

what are some factors of cardiogenic shock

A

structural problems, arrhythmias, ineffective forward flow

8
Q

what are the structural problems of cardiogenic shock

A

valvular insufficiency (back flow)
HCM - felines, diasystolic failure
DCM - canines, weakened contractions, poor contractility

9
Q

what is obstructive shock

A

obstruction of blood flow from/returning to the heart -? diminished blood volume

10
Q

what are some causes of obstructive shock

A

GDV, caval syndrome, pulmonary embolism, pericardial effusion/pneumothorax

11
Q

what is distributive shock

A

flow maldistribution - vascular compartment expands (hypoperfusion despite adequate blood volume)

  • loss of vessel tone
  • injected mm
12
Q

what are some potential causes of distributive shock

A

sepsis, SIRS, anaphylaxis, neurogenic disorder

13
Q

what is SIRS

A

systemic inflammatory reponse

14
Q

what are the clinical signs of systemic inflammation in response to infectious or noninfectious insults

A

trauma, pancreatitis, burns, venom, neoplasia, heart stroke

15
Q

what is sepsis

A

the clinical syndrome caused by infection and the host’s systemic inflammatory response to it
(may be bacterial, viral, protozoal, or fungal origin)

16
Q

what are the perfusion parameters

A

mentation, mm/crt, HR, pulse quality, extremity temp, BP

17
Q

how is the shock index calculated

A

HR over systolic blood pressure, higher than 1 = patient in shock

18
Q

what are the stages of shock

A

compensatory stage, early decompensatory stage, decompensatory stage (terminal)

19
Q

what si the compensatory stagge

A

animal attempts to maintain O2 delivery to the tissue

20
Q

what are the 2 responses in the compensatory stage

A

sympathetic and neurohormal

21
Q

what is the sympathetic response in the compensatory stage

A

increased CO by increased HR and SV

22
Q

what is the neurohormonal response in the compensatory stage

A

water retention and fluid shift from interstitial to intravascular space

23
Q

what may happen in the compensatory stage

A

splenic contraction may occur to increase number of circulating RBCS, more RBCS = more oxygen to be able to be carried

24
Q

what are the clinical signs of the compensatory stage

A

tachycardia, tachypnea, normal rec temp, normal to slow hypertensive, pink mm, cool extremities, normal mentation, prolonged CRT

25
Q

if the compensatory stage is untreated due to inadequate intravasculcar volume what happens

A

decreased systemic vascular resistance, cardiac dysfunction, patient goes into early decompensatory

26
Q

what are the clinical signs of the early decompensatory stage

A

tachycardia, prolonged CRT, weak pulse, pale mm, possible decrease in temp, decreasing BP< dull mentation (caused by lacatate acidosis)

27
Q

what are the clinical signs of terminal stage/ late decompensatory stage

A

as a result of organ failure - bradycardia, pale/cyanotic mm, absent CRT, weak or no pulse, hypotheromic, anuria

28
Q

what is the terminal stage

A

happens with the stage before is not treated effectively, severe intravascular volume loss, autoregulatory escape, multi-organ failure, sympathetic center of the brain doesnt work

29
Q

what is the autoregulatory escape

A

local responses override sympathetic response, massive vasodilation in all organ - complete circulatory collapse

30
Q

what is the early decompensatory stage

A

redistribution of blood flow to preferred organs (heart and brain), overwhelmed liver, myocardial depressant factor, hypoxia,lactic acid production