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Flashcards in Physiology of shock Deck (19)
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1
Q

What is shock?

A

Shock is inadequate perfusion leading to inadequate oxygen delivery and eventually organ failure

2
Q

What causes shock?

A

Either a problem with the heart, blood vessels or the flow of blood

3
Q

Name the 5 types of shock

A

Cardiogenic, neurogenic, septic, anaphylactic and hypovolaemic

4
Q

What is distributive shock?

A

Distributive shock is an umbrella term for septic, anaphylactic and neurogenic shock. There is sufficient fluid but it is in the wrong place

5
Q

What is the key issue in hypovolaemic shock?

A

Loss of intravascular volume

6
Q

In which kind of shock is heart failure the key issue?

A

Cardiogenic shock

7
Q

What is the key issue in septic shock?

A

Toxins and malfunction at the capillary level

8
Q

In which type of shock is mast cell degranulation the key issue?

A

Anaphylactic shock

9
Q

What is the key issue in neurogenic shock?

A

Loss of sympathetic outflow in thoracic spine leading to lack of feedback

10
Q

How does neurogenic shock differ from the other types of shock in terms of heart rate?

A

Neurogenic shock causes bradycardia, every other type of shock causes tachycardia

11
Q

How would you treat hypovolaemic shock?

A

Fluid and blood replacement

12
Q

How would you treat cardiogenic shock?

A

Careful fluid management, ionotropes e.g. dobutamine, vasopressor drugs e.g. noradrenaline

13
Q

How would you treat septic shock?

A

Sepsis 6 (BUFALO) and vasopressor if fluid unresponsive

14
Q

How would you treat anaphylactic shock?

A

Adrenaline is first line treatment

15
Q

How would you treat neurogenic shock?

A

Vasopressors

16
Q

What is meant by cardiac arrest?

A

It does not necessarily mean the heart has stopped beating, it means that cardiac output is not sufficient for a palpable carotid pulse

17
Q

What are the reversible causes of cardiac arrest?

A

4 Hs - hypovolaemia, hypoxia, hypothermia and hyperkalaemia

4 Ts - toxins, thrombus, tension pneumothorax and cardiac tamponade

18
Q

In which cardiac arrythmias is immediate defibrillation appropriate?

A

Ventricular fibrillation and pulseless ventricular tachycardia

19
Q

What is the more popular theory as to why CPR works?

A

It changes the intra-thoracic pressure and creates a gradient for blood flow to continue