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Flashcards in Shock and circulation Deck (13)
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1
Q

Define shock

A

Lack of perfusion to tissues, leading to inadequate O2 delivery to vital organs.

2
Q

Type of shock

A

Cardiogenic

Hypovolaemic

Distributive

3
Q

Cardiac output

A

Volume of blood pumped out of the left ventricle/ min

CO= SV x HR

4
Q

Factors that affect CO

A

Preload
- Stretching of ventricles end diastole

Afterload
- Resistance left ventricles have to overcome.

Contractility

5
Q

Blood pressure

A

CO x SVR

6
Q

Consequences of low BP

A

Brain
- unconsciousness, confusion, delirium

Kidney
- Decreased urine output

Gut
- Necrosis–> perforation–> peritonitis

Heart
- Decreased contractility, cardiac arrest

Skin
- Cold.

7
Q

Causes of cariogenic shock

A
  • Heart failure
  • MI
  • Cardiomyopathy/ Valvopathy
  • Arrythmia (i.e. AF, VF, VT)
8
Q

Causes of distributive shock

A
  • Sepsis
  • Anaphylaxis
  • Neurogenic (loss of autonomic pathway due to spinal cord disruption
9
Q

Causes of hypovolaemic shock

A

Dehyradation

Haemorrhagic

10
Q

Signs of shock

A
B- 
High resp rate (24+)/ Increased respiratory effort
Low O2 (<95)
High lactate (>2), CRP
Cyanose
C- 
Low BP 
(<80)
Decreased Urine output (<0.5ml/kg/hr)
Cold, clammy, very warm, red

D
- Decreased GCS/ VPU: drowsy, confused, unconscious

E
- Signs of blood loss

11
Q

Assessing shock

- LLF

A
Look
- Signs of poor perfusion? 
Grey, clammy
Cyanose
V. red?
Capillary refill
- Respiratory effort
Accessory muscles?
- Bleeding
- Oligouria
Listen
- Breathing?
Stridor
Wheeze/ crepitation
- Heart sounds
murmur? valve disease
- BP?
Feel
- Pulse (central and peripheral)
Rate?
Thready?
Arrhythmia?
- Temperature
- Chest percussion
12
Q

Initial management of shock

A

A
- Keep patent

B

  • Ventilate if necessary
  • High flow O2

C

  • Fluid challenge: 10ml/Kg
  • Stop bleeding

Reassess interventions

13
Q

Further management of shock

A

B

  • Chest X-ray
  • ABG

C

  • ECG
  • Bloods: culture, U&Es, group and save

Drugs

  • Noradrenaline to increase BP
  • Dobutamin to increase contractility AND BP