Sepsis/shock
hypotension, hypovolemia, mental status changes, decreased urine output, respiratory failure, GI dysfunction,
What are s/s of septic shock?
Few if any clinical symptoms, metabolism changing at cellular level from aerobic to anaerobic, lactic acid is building up
What is the Initial stage of shock?
increases CO and HR,BP, CVP
What is epinephrine?
This is required to keep lungs partially inflated after each breath
What is PEEP
draining of fluid, re-establish negative pressure
Why are chest tubes used
30mL/kg of an isotonic solution
What is fluid resuscitation for septic shock?
Mental status changes, severe decrease in CO, V/Q mismatch, AKI
What is progressive stage of shock?
Used to keep MAP >65, increased myocardial contractility, increased BP, HR, CO
What is dopamine?
The patients is biting the ET tube or has a lot of secretions
What is a high pressure alarm
collection chamber, water seal chamber, suction control chamber
what are the parts of a chest tube?
Jugular vein distention and paradoxical pulse
What are s/s of obstructive shock?
Hypotension, narrowing pulse pressure, increased HR, cool clammy skin.
What is the compensatory stage of shock?
increased myocardial contractility, decreases ventricular filling pressures,
What is dobutamine?
The vent has come apart.
What is a low pressure alarm
tidaling, bubbling, VS, education
What is normal for a chest tube?
patient has angioedema, bronchoconstriction, dizziness, respiratory distress
What is anaphylactic shock?
severe interstitial edema, worsening hypotension, MODS
What is refractory stage of shock?
decreased inflamation, increases BP, HR, reverses increased capillary permeability,
What is hydrocortison?
such as barotrauma, pneumothorax, low blood pressure, low CO
Complications of PEEP
drainage greater than 200mL/hr, vigorous bubbling, no tidaling after insertion.
What are abnormal findings in chest tubes?
GI bleed, hypotension,anxiety,pallor
What are s/s of hypovolemic shock?
bradycardia, dysregulated thermoregulation, massivie vasodilation
What is neurogenic shock?
antibiotic would be used in septic shock
What is vancomycin?
Fever, cloudy, thick secretions, crackles increased WBC
What are s/s of VAP
bright red drainage more than 200mL/hr
chest tube came out, patients VS tanking
When would you notifity the MD