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What am I? I am a critcal condition in which systemic BP is inadequate to provide perfusion to the vital organs & peripheral tissues.
What is the pathophysiology of shock?
Hypoperfusion leads to decreased O2 delivery & nutrients to the tissues = Cellular dysfunction
What part does the SNS & RAAS play in compensated shock?
Arterial pressure is maintained briefly by compensatory physiological responses unfortunately they will eventually fail. Designed to maintain CO & BP
The SNS has two types of adrenergic receptors, alpha & Beta. What function does alpha recpector cause on the heart?
Vasoconstriction = more circulating volume returning to the heart improving BP
What type of shock am I? All vital organs are under perfused. Rapid detection can reverse process. Due to the anerobic response an increase in free radicals and latic acid, adrenaline is less effective at this stage?
Name the four classifications of shock?
- Hypovolemic - Loss of BV
- Cardiogenic - Problem with myocardium
- Distributive - Maldistribution of circulating volume ie septic
- Obstructive - Decrease tissue perfusion 2nd to an obstruction ie embolisum
If a pt was in Distributive shock what would be the major difference from other types of shock?
The pt would be warm to touch due to vasodilation more blood pooling in the peripheral arteries. Sluggish in flow
Name some innocent bystanders of shock?
- Heart - Decrease in supply, increase in demand, increase afterload. Ischemia and decreased contractility
- Lungs - Increase in pulmonary vascular resistance = R Vent failure
- Gut -Impaired intestinal barrier allows toxins in to the blood.
Name some of the early recognition of shock?
- Cold clammy skin due to decreased perfusion
- Cold kneecaps
- Level of consciousness
- Fine tremors hands & tongue - due to adrenaline release
- Lacy blue discolouration due to venodilation and slow BF
If the neck veins were flat inobstructive and distened, what type of shock would this be?
Would you use fluid therapy in Hypovolemic shock?
Yes, as it is loss of BV.
From a pharmacotherapy aspect would you use for shock?
- Dextrose - Hypoglycaemic
- Antibiotics - Septic Shock
- Ventalation -
- Intra-Aortic Ballon Pump - Located 2cm down from the arotic arch