Types of Shock
Shock caused by massive loss of blood volume
What is hypovolemic (or hemorrhagic shock)
Lab most useful to identify tissue hypoperfusion
What is lactate
Most common cause of preventable death in trauma
What is hemorrhage
First step in any shock management
What is ABCs (Airway, breathing, circulation)
Vasopressor of choice in septic shock
What is norepinephrine
Shock caused by pump failure, often post-MI
What is cardiogenic shock?
Blood pressure is maintained by which 2 factors?
What is CO and SVR
FAST exam is used to detect
What is free fluid in the abdominopelvic cavtiy
Type of fluid preferred for mid to late hemorrhagic shock
What is blood products
Vasopressor (s) that also increases heart rate
What is norepinephrine & dopamine (dose dependent)
Shock due to obstruction to blood flow
What is obstructive shock (e.g. PE, tamponade)
Hemodynamic measure often low in hypovolemic shock
What is CVP
Initial fluid of choice in trauma resuscitation
What is isotonic crystalloids (NS or RL)
When to consider vasopressors
What is after adequate fluid resuscitation & persistent hypotension
In cardiogenic shock with low perfusion, may use?
Dobutamine, milrinone
What shock demonstrates preserved global perfusion with impaired use of oxygen at the tissue level
What is septic shock
Classic lab pattern in hemorrhagic shock
What is anemia + metabolic acidosis
Trauma related coagulopathy diamond
Goal MAP (s) in most shock states
What is MAP > 65mmHg or 60mmHg for the elderly
Mechanism: phenylephrine
What is pure alpha-1 agonist (vasoconstriction)
What a form of shock leading to hypoperfusion and refractory vasopressor response, with hyponatremia and hyperkalemia
What is adrenal insufficiency
What is this hemodynamic profile: low CO | high SVR | high CVP | low PCWP
What is obstructive shock - Pulmonary embolism (PE)
Massive transfusion protocol is defined as
10+ PRBCs in 24h or >4U PRBCs in 1hr; blood deliviered in a 1:1 fashion (4PRBCs: 4 FFP: 1plt)
Why is over-resucitation harmful
Risk of edema, ACS, dilutional coagulopathy and ARDS
Vasoconstrictive and inotropic effects contributing to effectiveness in cardiac arrest and shock states but not first line in sepsis
What is epinephrine