SIRS & CARS
What does SIRS stand for?
Systemic Inflammatory Response Syndrome
What is sepsis (aka: septicemia)?
bloodstream infection
What does MODS stand for?
Multiple Organ Dysfunction Syndrome
What are the 3 stages of shock? And what are the goals?
1. Initial: compensate to maintain perfusion
2. Progressive: conserve blood for heart and brain
3. Irreversible: no goal, organelles fail, cell dies, and release lysosomal enzymes
Timmy has an allergic reaction to peanuts at a b-day party. He has swelling of the throat, bronchoconstriction, stridor, wheezing, and respiratory distress. Name the shock.
Anaphylactic Shock
How can this CARS lead to an increased risk of infection when it’s supposed to be a
compensatory reaction?
CARS leads to immunosuppression making the patient susceptible to secondary infection.
What is the most common type of sepsis?
Bacterial Sepsis
What is happening in MODS to the body?
Release of toxic metabolites and destructive enzymes in response to hypoxia
Define shock
The inability of the heart and lungs to perfuse needs of peripheral tissues.
Granny just got out of surgery from a double hip replacement. She has bradycardia and hypotension with warm dry skin. Name the shock.
Neurogenic Shock
What symptoms do we use to diagnose SIRS?
temp > 100.4 or <96.8
HR>90 bpm
RR >20 or PaCO2 <32mmHg
WBC >12,000 or <4,000
What are the symptoms of severe sepsis?
Renal failure, hypotension, disseminated intravascular coagulation (DIC)
What theory describes decreased blood flow with increased permeability allowing GI contents to be released?
Gut Theory
All types of shock converge to the same physiological pathway. What are they
Cellular hypoxia, anaerobic metabolism, and lactic acidosis
Bethany Hamilton lost her arm to a hungry shark. She is having tachycardia with a weak, thread pulse. RAAS and SNS are activated. Name the shock.
Hypovolemic Shock
During SIRS what 2 bodily functions decrease?
GI function and Urine Output
What symptom of septic shock is most life-threatening?
Hypotension
Increase in volume requirements, mild respiratory alkalosis. oliguria, hyperglycemia, and increased insulin requirements are symptoms of what stage in MODS?
Stage 1
What 3 types of shock are classified as disruptive: massive vasodilation
neurogenic, septic, and anaphylactic
Grandpa Joe is an obese, 67-year-old male. He has a low UO, cyanosis, altered mental status, elevated HR, and severe hypotension. Name the shock
Cardiogenic shock
What can SIRS and CARS progress to?
Sepsis
3 things increase in septic shock 1 thing decreases, what are they?
What is the eventual outcome if MODS is not reversed?
You kick the bucket
What are the body's 2 responses to shock?
Inflammatory response and lactic acidosis
Ella's blood sugar is through the roof!!! Insulin isn't doing the trick either. Epinephrine and cortisol are high and WBC function is low. Name the shock
Septic Shock