Shock II (care for shock pt)
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What is emergency care for the shock pt?
- keep pt still
- prevent heat loss
- Monitor and record vitals.
What is Rothberg's position and why would you use it?
- HOB 45 degrees, feet/legs elevated 15.
- Use for shock pt who has is having difficulty breathing.
What is initial management of hypovolemic shock?
- Find and control hemorrhage. Could also be internal.
- Restore volume by infusing crystalloids (LC, 3-5% NaCl) and blood/blood products. Watch for e-lyte imbalances especially in dehydration hypovolemia.
- Airway and admin O2.
What is initial management of cardiogenic shock?
- Restore or replace heart function.
- Invasive monitoring (swangans).
- Agressive airway maintenance
- Fluid replacement
- --Dobutamine for tachy + ^ SVR
- --Dopamine for tachy + v SVR
- --*both will ^ contractility
- Other drugs
- --morphine for anti-anxiety
- --cautious use of diuretics for CHF
- --Vasodilators for afterload reduction
- --Short acting BBlockers (esmolol) for refractory tachy.
- Consider thrombolytics, angioplasty, and aortic balloon counterpulsation if appropriate.
What is initial management of septic shock?
- Fluid resusitation
What is MODS?
- Multiple Organ Dysfunction Syndrome
- leading cause of death in trauma or sepsis
- High mortality rate (40-90%)
- In shock, is caused secondary to poor organ perfusion and inflammation
Interventions for MODS?
- Balance O2
- Nutritional support
- Control source of inflammation/nfxn
What causes ARDS in shock pts?
Hypoxic destruction of alveolar/capillary interface.
What would you like to do?
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