shock atls

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Author:
ambulans
ID:
232127
Filename:
shock atls
Updated:
2013-08-31 04:47:19
Tags:
trauma schock
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Description:
schock in trauma
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  1. Definition of shock
    insufficient tissue perfusion och oxygenation
  2. unresponsive to shock treatmet
    undiagnosed bleeding? cardiac tamponade? tension pneumothorax? ventilatroy problems? fluid loss? acute gastric distension? MI? Ketoacidosis? hypoadrenalism? neurogen schock?
  3. specialĀ case athletes
    more blodd volume 15-20%, CO x 6, resting pulse 50 CAVE severe blodd loss but little symptoms
  4. CAVE medications
    • b blockers --> no responsive takycardia
    • Ca--> alter hemorragic response
    • insulin --> hypoglycemia
    • diuretics --> hypo -K
    • NSAID --> adverse platelet function
  5. Hypothermia
    Must be avoided, core rewarming, external rewarming-.
  6. neurogen shock
    VD + bradykardia + warm and dry skin

    Fluid + atropin (0,5g--> 0,75-1,0gĀ  after 10min)
  7. Pacemaker
    not responding with takykardia
  8. special considerations with elderly
    - less sympathetic activity due to deficit in adrenerg receptors

    - cardiac compliance decreases

    - b-blockers bradykardia!

    - preexisting volme depletion

    - worse pulmonary completion

    - reduced kidney function(worse fluid preservation), longer time to for toxics to exit
  9. Ohms law
    V=IxR

    BP= CO x VR

    --> only resistance increase will give BP increase but not better perfusion
  10. clinical symptoms of shock
    pulse rate, BP, pulse character, respiratory rate, skin circulation, pulse pressure
  11. Any patient who is cool and tachycardic ....
    ... is in shock until proven otherwise.
  12. Tachycardia infant
    > 160
  13. Tachycardia pre-school
    >140
  14. Tachycardia school age to puberty
    > 120
  15. Tachycardia adult
    > 100
  16. Hematocrit and Hemoglobin...
    unreliable values fpr determination of shock.

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