Shock Basics
The hallmark of all forms of shock (What does shock result in on a broad level)
What is decreased tissue perfusion and impaired cellular metabolism?
During this stage of shock, changes occur only at the cellular level
What is the initial stage?
The primary problem in hypovolemic shock
What is inadequate intravascular volume?
The three subtypes of distributive shock?
Bonus: The two hallmarks of all distributive shock?
What is neurogenic, anaphylactic, and septic shock?
What is vasodilation and relative hypovolemia
How many SIRS criteria are needed to meet the definition of SIRS
BONUS: SIRS criteria
What is two or more?
What is a temperature above 38 or below 36, a heart rate above 90 BPM, a respiratory rate above 20 and a white blood cell count above 20 or less than 4
The four major categories of shock
What are hypovolemic, distributive, cardiogenic, and obstructive
During this stage, compensatory mechanisms maintain perfusion and oxygenation
What is the compensatory stage?
Examples of absolute volume loss
What is hemorrhage, vomiting, diarrhea, and diuresis?
This type of shock commonly follows cervical or high thoracic spinal cord injuries?
What is neurogenic shock?
SIRS plus this indicates the patient has sepsis
What is a suspected or confirmed infection?
Formula that calculates cardiac output
What is CO= HR x SV
Increased respiratory rate, tachycardia, agitation, and declining BP occur during this stage.
What is the progressive stage?
Fluid shifting from the vascular space into tissues is called this?
Bonus: What type of fluid volume loss is this?
What is third spacing?
What is relative volume loss (relative hypovolemia)
This medication is the first-line treatment for anaphylactic shock?
BONUS: Second line treatment for anaphylactic shock?
What is epinephrine?
What is IV diphenhydramine, famotidine, steroids, and bronchodilators.
The recommended initial fluid bolus for septic patients?
What is a 30 mL/kg isotonic crystalloid?
The minimum MAP needed to adequately perfuse organs
What is 65 mmHG
Profound hypotension, hypoxemia, and accumulation of lactate occurs during this stage?
What is the refractory stage?
In hemorrhagic shock what is the preferred fluid replacement?
Bonus: Why?
What is blood?
What is replacing lost blood restores oxygen carrying capacity?
Histamine released during anaphylaxis causes these two major vascular changes.
What is vasodilation and increased capillary permeability?
Sepsis Criteria plus this indicates the patient has been become severely septic
What is evidence of organ dysfunction, hypotension, hypoperfusion.
The three factors that infleunce stroke volume
What is preload, afterload, and contractility
Increased levels of this laboratory value indicate tissues have switched to anerobic metabolism
What is lactate?
Before administering vasopressors in hypovolemic shock, you must first do this
What is restore volume?
This type of shock presents with bradycardia.
What is neurogenic shock?
Three primary physiologic effects of septic shock
What is vasodilation, maldistributed blood flow, and myocardial depression.