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Questions and Answers
You suspect your patient is in shock. You note the patient's skin is pale. This is likely due to ___________.
You suspect your patient is in shock. You note the patient's skin is pale. This is likely due to ___________.
- An increased heart rate
- Peripheral vasodilation
- Peripheral vasoconstriction (correct)
- Hypothermia
Pulmonary edema and impaired ventilation occur during:
Pulmonary edema and impaired ventilation occur during:
- Septic shock
- Cardiogenic shock (correct)
- Neurogenic shock
- Anaphylactic shock
Distributive shock occurs when:
Distributive shock occurs when:
- An injury causes restriction of the heart muscle and impairs its pumping function.
- Widespread dilation of the blood vessels causes blood to pool in the vascular beds. (correct)
- Temporary but severe vasodilation causes a decrease in blood supply to the brain.
- Severe bleeding causes tachycardia in order to distribute blood to the organs faster.
Which of the following injuries would MOST likely cause obstructive shock?
Which of the following injuries would MOST likely cause obstructive shock?
Hypovolemic shock caused by severe burns is the result of a loss of:
Hypovolemic shock caused by severe burns is the result of a loss of:
Your patient is in shock, but the body's defense mechanisms are currently able to maintain adequate circulation. This is called ___________.
Your patient is in shock, but the body's defense mechanisms are currently able to maintain adequate circulation. This is called ___________.
When should nonlifesaving interventions be performed for your multisystem trauma patient?
When should nonlifesaving interventions be performed for your multisystem trauma patient?
When treating an 80-year-old patient who is in shock, it is important to remember that:
When treating an 80-year-old patient who is in shock, it is important to remember that:
To protect vital organs, the body compensates by directing blood flow away from organs that are more tolerant of low flow, such as:
To protect vital organs, the body compensates by directing blood flow away from organs that are more tolerant of low flow, such as:
What are the three components of the 'perfusion triangle'?
What are the three components of the 'perfusion triangle'?
Shock due to severe infection is called ________.
Shock due to severe infection is called ________.
As you approach a patient lying at the side of the roadway, you observe severe bleeding from the leg. What should your first action be?
As you approach a patient lying at the side of the roadway, you observe severe bleeding from the leg. What should your first action be?
In an acute injury setting, neurogenic shock is commonly accompanied by:
In an acute injury setting, neurogenic shock is commonly accompanied by:
When assessing a patient with signs and symptoms of shock, it is important to remember that:
When assessing a patient with signs and symptoms of shock, it is important to remember that:
Inadequate circulation of blood throughout the body is called ________.
Inadequate circulation of blood throughout the body is called ________.
A 20-year-old male has a large laceration to his wrist. He is holding a blood-soaked towel over the wound, but it continues to bleed rapidly. You should:
A 20-year-old male has a large laceration to his wrist. He is holding a blood-soaked towel over the wound, but it continues to bleed rapidly. You should:
Your patient has a decreased cardiac output and poor myocardial contractility. This will likely lead to ___________.
Your patient has a decreased cardiac output and poor myocardial contractility. This will likely lead to ___________.
Which of the following is the ONLY action that can prevent eventual death from a tension pneumothorax?
Which of the following is the ONLY action that can prevent eventual death from a tension pneumothorax?
A 25-year-old unrestrained female struck the steering wheel with her chest when her car hit a tree while traveling at a high rate of speed. She has signs and symptoms of shock, which you suspect are the result of intrathoracic bleeding. Which of the following interventions will provide this patient with the greatest chance for survival?
A 25-year-old unrestrained female struck the steering wheel with her chest when her car hit a tree while traveling at a high rate of speed. She has signs and symptoms of shock, which you suspect are the result of intrathoracic bleeding. Which of the following interventions will provide this patient with the greatest chance for survival?
Foods, medications, and insects are common causes of ________.
Foods, medications, and insects are common causes of ________.
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Study Notes
Shock Overview
- Shock is characterized by inadequate circulation of blood throughout the body, leading to potential organ failure.
- Blood pressure may be the last measurable factor to change during shock.
Types of Shock
- Cardiogenic Shock: Results from poor myocardial contractility and decreased cardiac output; leads to pulmonary edema.
- Hypovolemic Shock: Caused by significant loss of plasma, such as from severe burns.
- Septic Shock: Triggered by severe infections, leading to systemic vasodilation.
- Anaphylactic Shock: Induced by allergic reactions to foods, medications, or insects.
- Obstructive Shock: Often due to conditions like cardiac tamponade or tension pneumothorax that impede heart function.
- Distributive Shock: Occurs with widespread vasodilation, causing blood pooling in vascular beds.
Signs and Symptoms
- Pale skin often indicates peripheral vasoconstriction.
- Patients may experience hypothermia in neurogenic shock.
- Altered gastric motility in older patients can increase the risk of vomiting.
Compensatory Mechanisms
- Compensated shock occurs when the body maintains adequate blood circulation despite shock.
- Blood flow may redirect from less critical organs to vital ones, such as the heart and brain.
- The skin is often a target for reduced blood flow during shock.
Assessment and Initial Actions
- Control bleeding immediately when severe hemorrhaging is observed.
- Non-lifesaving interventions should be performed en route to the hospital.
- In cases of tension pneumothorax, decompression of the injured chest side is crucial to prevent death.
Management
- Applying a tourniquet proximal to a rapidly bleeding site is essential.
- Rapid transport to a trauma center is critical for patients with signs of intrathoracic bleeding after major trauma.
Physiological Considerations
- Changes in structures and functions, such as vascular resistance and heart rate, are vital in managing shock.
- Older adults may have a slower compensatory response due to various medications affecting heart rate and blood flow.
Key Components
- The "perfusion triangle" consists of the heart, blood vessels, and blood.
- Cardiovascular stability is necessary to maintain adequate perfusion and oxygen delivery to organs.
Important Interventions
- High-flow supplemental oxygen can be beneficial, but should be used with consideration of the patient’s conditions.
- Immediately address airway management and breathing difficulties in suspected cases of shock.
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