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RCulwell
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Definitions of sepsis:
SIRS plus source of infection
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Definition of SIRS:
- 1. Tm>38 (or<36)
- 2. HR>90
- 3. RR>20
- 4. WBC>12,000 (or<4,000)
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Beck's Triad:
- 1. Hypotension
- 2. Decreased heart sounds
- 3. Jugular venous distension
These are sings of cardiac tamponade
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Class I shock (blood loss, HR, BP, UO, CNS)
- Class I:
- Blood loss: <15% (<750)
- HR: <100
- BP: normal
- UO: >30/h
- CNS: normal
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Class II shock (blood loss, HR, BP, UO, CNS)
- Class II:
- Blood loss: 15-30% (<750-1,500)
- HR: >100
- BP: normal
- UO: 20-30/h
- CNS: anxious
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Class III shock (blood loss, HR, BP, UO, CNS)
- Class III:
- Blood loss: <30-40% (<1,500-2,000)
- HR: >120
- BP: decreased
- UO: 5-15/h
- CNS: confused
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Class IV shock (blood loss, HR, BP, UO, CNS)
- Class IV:
- Blood loss: >40% (>2,000)
- HR: >140
- BP: decreased
- UO: 0/h
- CNS: lethargic
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Consider running this test in a critically ill patient who is hypotnensive and refractory to high dose steroids.
Check serum cortisol levels (rule out adrenal shock)
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Name that shock:
CVP: low
CO: low
SVR: high
SvO2: low
- Hypovolemic shock:
- CVP: low
- CO: low
- SVR: high
- SvO2: low
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Name that shock:
CVP: high
CO: low
SVR: high
SvO2: low
- Cardiogenic:
- CVP: high
- CO: low
- SVR: high
- SvO2: low
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Name that shock:
CVP: high/low
CO: high
SVR: low
SvO2: high
- Hyperdynamic Septic Shock
- CVP: high/low
- CO: high
- SVR: low
- SvO2: high
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Name that shock:
CVP: low
CO: low
SVR: low
SvO2: low
- Neurogenic Shock:
- CVP: low
- CO: low
- SVR: low
- SvO2: low
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Name that shock:
CVP: high/low
CO: low
SVR: high
SvO2: high/low
- Hypodynamic Septic Shock:
- CVP: high/low
- CO: low
- SVR: high
- SvO2: high/low
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At what level of vertebrae would spinal cord transection cause neurogenic shock?
"Above 4th thoracic 4 neurogenic"
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