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Flashcards in Shock Deck (19)
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1
Q

What are the main types of shock? (4)

A

Hypovolemic
Cardiogenic
Distributive
Obstructive

2
Q

What are the three general signs of all types of shock?

A

What are the three general signs of all types of shock?
Low BP
Decreased urine output
Altered mental status

3
Q

What happens during pre-shock?

A

The body compensates for diminished tissue perfusion. May be asymptomatic up to 10% reduction in total effective arterial blood volume.

4
Q

What are SSX for early shock?

A
Hypotension
Tachycardia
Dyspnea
Mental confusion
Restlessness
Diaphoresis
Cool, clammy skin
5
Q

Which type of shock can result from burns, excessive vomiting, diarrhea, severe exfoliation, or internal or external loss of blood?

A

Hypovolemic

6
Q

What are some risk factors for hemostasis in hypovolemic shock?

A

Disorders involving vascular integrity, platelet number or function, coagulation factors, or medications (NSAIDS, coumadin)

7
Q

What is the mechanisms of most NSAIDS?

A

Inhibitions of the COX 1 and 2 enzymes (Ibuprofen, which is reversible. Aspirin is irreversible)

8
Q

What tests are run for Coumadin? for Heparin?

A

Coumarin - PT (prothrombin time)

Heparin - PTT (partial thromboplastin time)

9
Q

How is the shock index calculated?

A

HR/systolic BP

10
Q

What is the normal range of shock index?

What predicts nine times the risk of massive transfusion?

A

Normal = 0.5 - 0.7

> 1.3

11
Q

Up to what percentage of blood loss is a Class I hemorrhage?

A

15%; vital signs are usually normal, fluid resuscitation is not usually necessary.

12
Q

What is a common skin finding consisting of reticulated vascular pattern that may occur during shock?

A

Livedo reticularis

13
Q

What percentage of blood volume loss is a Class III and IV hemorrhage?

A

III - 30-40%

IV - >40%

14
Q

If a BP cuff is unavailable which palpable peripheral pulses indicate an approximate systolic BP?

A
Radial = 80
Brachial = 70
Femoral = 60
Carotid = 50
15
Q

Should you consider food or drink for someone in shock?

A

No, they may need emergency surgery.

16
Q

What results in cardiogenic shock?

A

Inadequate circulation of blood due to primary failure of the ventricles of the heart.

17
Q

What type of shock occurs even though the output of the heart is at or above a normal level? What causes are included in this type?

A
Distributive shock:
Septic
Anaphylactic
Neurogenic
Vasodilator drugs
Endocrine related
18
Q

What is the most common cause of distributive shock?

A

Sepsis

19
Q

What defines obstructive shock?

A

Physical obstruction of the great vessels or the heart itself.