What are potential causes of cardiogenic shock?
Inadequate heart function
Disease of muscle tissue
Impaired electrical system
Disease or injury
S/S of cardiogenic shock
chest pain irregular, weak pulse low BP cyanosis cold, clammy skin anxiety crackles pulmonary edema
What are potential causes of obstructive shock?
Mechanical obstruction of the cardiac muscle causing a decrease in CO
S/S of obstructive shock
dyspnea rapid, weak pulse rapid, shallow breaths decreased lung compliance unilateral, decreased, or absent breath sounds decreased BP JVD subcutaneous emphysema cyanosis tracheal deviation toward affected side Beck triad (tamponade)
narrowing pulse pressure
muffled heart tones
What is the cause and s/s of septic shock?
Severe bacterial infection
warm skin or fever tachycardia low BP weak, thready pulse shallow, rapid respirations AMS
What is the cause and s/s of neurogenic shock?
Damage to c-spine causing widespread blood vessel dilation
bradycardia or nl pulse
signs of c-spine injury
S/S of anaphylactic shock
What causes psychogenic shock?
Temporary, generalized vascular dilation causing syncopal episode
What is hypovolemic shock and s/s?
loss of blood or fluid
rapid, weak pulse low BP AMS cyanosis cool, clammy skin
What does a pediatric pt’s body rely on to help with compensation?
Increasing pulse and SVR
What are the common cause of severe allergic reactions?
Injections : tetanus, antitoxin, penicillin
Stings : wasps bees, hornets, ants
Ingestion : fish, shellfish, nuts, eggs, medication
Inhalation : dust, pollen, mold
What is the progression of shock?
S/S of compensated shock
agitation, anxiety, restlessness sense of impending doom weak, rapid (thready) pulse moist, clammy skin pallor, cyanotic lips SOB n/v delayed cap refill thirst narrowing pulse pressure
S/S of decompensated shock
AMS hypotension narrowing pulse labored or irregular breathing thready or absent peripheral pulses ashen, mottled, or cyanotic skin dull eyes, dilated pupils diminished urine output diaphoresis thirst decreased cap refil dry mucosa n/v
What happens during the compensated shock stage?
Chemical release by ANS causes arterial BP to remain nl or slightly elevated
Increase in rate and depth of respirations to bring in more oxygen and C02.
Why does the body increase rate and depth of respirations during compensated shock?
Attempt to maintain acid-base balance by creating respiratory alkalosis to offset metabolic acidosis.
What occurs during decompensated shock?
Blood volume decrease more than 30%.
Compensatory mechanisms begin to fail.
CO falls dramatically reductions BP and cardiac function.
Vasoconstriction in order to shunt blood to brain, heart, lungs, and kidneys.
Initial management of shock
Control obvious bleeding Manage airway Amdminister supplemental oxygen PLace in position of comfort Obtain vital sign including SpO2 and glucose Obtain IV/IO access Maintain body heat