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10 Cards in this Set
- Front
- Back
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585. General characteristics of Shock?
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a. Shock is equivalent to under-perfusion of tissues. It is a medical emergency that needs to be corrected right away, before it becomes irreversible.
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586. How does shock present?
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a. ↓ in BP and malfunction of under-perfused organ systems, most notably:
1. Lactic acidosis 2. Renal (anuria/oliguria) 3. CNS dysfunction (altered mentation) |
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587. What 4 sing/sx are common to all forms of shock?
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1. Hypotension
2. Oliguria 3. Tachycardia 4. Altered Mental status. |
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588. Initial approach to a pt in shock?
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a. Focused hx and physical exam to determine possible cause of shock.
i. Fever and possible site of infection suggest septic shock. |
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589. What symptoms suggest Hypovolemic shock?
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1. Trauma
2. GI bleeding 3. Vomiting 4. Diarrhea |
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590. What symptoms suggest Cardiogenic shock?
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a. Hx of MI, Angina, of heart disease.
b. If JVD is present, this suggests cardiogenic shock! |
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591. What symptoms suggest neurogenic shock?
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a. Spinal cord injury or neurologic deficits present.
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592. Initial steps in tx of shock?
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a. Establish 2 large-bore venous catheters, a central line, and an arterial line.
b. A fluid bolus (500-1000 ml of normal saline or lactated Ringer’s solution) should be given in most cases. c. Draw blood: CBC, electrolytes, renal function, PT/PTT d. ECG, CXR e. Continuous pulse oximetry. f. Vasopressors (Dopamine or Norepoi) may be given if the pt remains hypotensive despite fluids. |
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593. What can be done for shock if the diagnosis is still in question after the above tests?
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a. A pulmonary artery catheter and/or echo may help in diagnosis.
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594. Tx of Shock?
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a. ABCs should be addressed for all pts in shock!!!
b. With the exception of cardiogenic (and sometimes neurogenic), a generous amount f IV fluid is usually required to resuscitate the pt. c. The more advanced the stage of shock, the greater the fluid (and blood requirement). |
