Term
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Definition
Inadequate total body oxygen delivery
*the SHOCKer is something totally different |
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Term
What are the 4 types of shock?
What are their definitions? |
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Definition
1) hemorrhagic: loss of circulating fluid
2) cardiogenic: failure of heart to pump blood to tissues
3) anemic: decreased oxygen carrying capacity
4) neurogenic: loss of vascular tone |
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Term
| In the early stages of truama, what type of shock is assumed unless proven otherwise? |
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Definition
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Term
| What is the hematologic response to shock? |
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Definition
There is a activation of extrinsic/intrinsic clotting cascades which include:
-rapid consumption of clotting factors (platelets) resulting in a deficit
-release of thromboxane A2 = vasoconstriction and platelet aggregation |
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Term
| What is the cardiovascular response to shock? |
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Definition
catecholamine release, resulting in:
- increased HR
- increased contractility
- vasoconstriction
- shunting of blood from non-vital to vital organs
- baroreceptor response d/t circulating volume = reduced vagal outflow |
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Term
| What is the renal response to shock? |
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Definition
low renal blood flow leads to the release of:
renin
aldosterone
cortisol
erythropoietin
catecholamines |
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Term
| What is the neuroendocrine response to shock? |
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Definition
| increased release of ADH = reabsorption of H2O and Na |
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Term
| During hemorrhagic shock, blood supply is low which leads to an increase in cellular demand. What happens when there is decreased supply and increased demand? |
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Definition
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Term
| The degree of oxygen deficit is proportional to what? |
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Definition
rate of blood lost over time
(how quick & period of time blood loss occurs) |
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Term
| Let's say you wanted to put your finger on the pulse ;) What is the estimated systolic if you palpate a carotid? femoral? radial? |
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Definition
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Term
Here are some estimates of blood loss in trauma:
I didn't want to make up questions... |
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Definition
Unilateral hemothorax 3,000ml
hemoperitoneum w/ abd distension ~3,000ml
pelvic fx ~2,000ml
femur fx ~1,000ml
tibia fx ~500ml
small fx sites ~500ml |
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Term
| What are some considerations w/ IV access during the management of shock? |
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Definition
1) have minimum 2 lg bore (16g or >), short length
2) DO NOT place in injured extremity, fool!
3) 12g cordis > triple lumen
4) try to have access above & below injury
5) IJs and subclavians may require movement of C-spine
6) central lines are hard w/ hypovolemia |
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Term
| Anaerobic metabolism leads to acidosis. What are some effects from cellular shock? |
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Definition
myocardial depression
hypotension
hypercarbia
anticoagulation
arrhythmias |
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Term
| Are vasopressors a key treatment for hemorrhagic shock? |
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Definition
Hells no!
Oxygen and Volume are the key tx |
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Term
| How much blood is lost in Class III shock? Class I? Class IV? Class II? |
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Definition
Class III = 1500-2000ml
Class I = up to 750ml
Class IV = >2000ml
Class II = 750-1500ml
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