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Questions and Answers
What is shock?
What is shock?
It is life threatening circulatory failure that results in cellular and tissue hypoxia
What happens when the cardiac output is low?
What happens when the cardiac output is low?
RAAS happened
What is the primary function of the RAAS system?
What is the primary function of the RAAS system?
Renin converts angiotensinogen to angiotensin I. Angiotensin-converting enzyme (ACE) converts angiotensin I to angiotensin II, which then stimulates aldosterone release, vasoconstriction, and increases sodium and water retention.
What are the general signs of shock?
What are the general signs of shock?
whats Distributive shock
whats Distributive shock
what is Hypovolaemic
what is Hypovolaemic
whats Cardiogenic
whats Cardiogenic
what is Obstructive shock
what is Obstructive shock
Targeted therapies for hypovolemic shock
Targeted therapies for hypovolemic shock
target therapy for Cardiogenic shock
target therapy for Cardiogenic shock
target therapy for Obstructive shock
target therapy for Obstructive shock
target therapy for Distributive shock
target therapy for Distributive shock
Treatment of Shock
Treatment of Shock
Shock is a life-threatening circulatory ______ that results in cellular and tissue hypoxia.
Shock is a life-threatening circulatory ______ that results in cellular and tissue hypoxia.
The hallmark sign of shock has been a systolic blood pressure (SBP) less than ______ mmHg.
The hallmark sign of shock has been a systolic blood pressure (SBP) less than ______ mmHg.
Shock is initially ______ but can rapidly become irreversible, resulting in multi-organ failure and death.
Shock is initially ______ but can rapidly become irreversible, resulting in multi-organ failure and death.
Therapy aims to maintain oxygen delivery to vital organs and prevent ______ and cell death.
Therapy aims to maintain oxygen delivery to vital organs and prevent ______ and cell death.
Hypovolemic Shock is characterized by a reduction in ______ blood volume.
Hypovolemic Shock is characterized by a reduction in ______ blood volume.
Cardiogenic Shock is characterized by pump ______ and impaired contractility.
Cardiogenic Shock is characterized by pump ______ and impaired contractility.
Obstructive Shock is characterized by blockage of circulation to the tissues by impedance of outflow or ______ in the heart.
Obstructive Shock is characterized by blockage of circulation to the tissues by impedance of outflow or ______ in the heart.
Fluid resuscitation follows ______ research and National Institute for Health and Care Excellence (NICE) guidelines.
Fluid resuscitation follows ______ research and National Institute for Health and Care Excellence (NICE) guidelines.
The FASTHUG mnemonic stands for Feeding, Analgesia, Sedation, Thromboembolic prophylaxis, and ______.
The FASTHUG mnemonic stands for Feeding, Analgesia, Sedation, Thromboembolic prophylaxis, and ______.
Shock can be caused by a ______ output problem, leading to activation of the renin-angiotensin-aldosterone system (RAAS).
Shock can be caused by a ______ output problem, leading to activation of the renin-angiotensin-aldosterone system (RAAS).
Distributive shock is characterized by a maldistribution of ______, often due to vasodilation.
Distributive shock is characterized by a maldistribution of ______, often due to vasodilation.
The Surviving Sepsis Campaign provides guidelines for the management of ______, emphasizing early antibiotic administration and supportive measures.
The Surviving Sepsis Campaign provides guidelines for the management of ______, emphasizing early antibiotic administration and supportive measures.
Neurogenic shock occurs in the presence of acute spinal cord injury above ______, resulting in inhibited sympathetic outflow and dominance of the parasympathetic nervous system.
Neurogenic shock occurs in the presence of acute spinal cord injury above ______, resulting in inhibited sympathetic outflow and dominance of the parasympathetic nervous system.
Adequate perfusion is achieved when Systolic BP is equal to ______ mm Hg.
Adequate perfusion is achieved when Systolic BP is equal to ______ mm Hg.
Anaphylactic shock is a severe, whole body allergic reaction triggered by exposure to an ______.
Anaphylactic shock is a severe, whole body allergic reaction triggered by exposure to an ______.
Cardiogenic shock is defined by decreased ______ output (cardiac index).
Cardiogenic shock is defined by decreased ______ output (cardiac index).
Define sepsis and septic shock according to Sepsis 3
Define sepsis and septic shock according to Sepsis 3
Define sepsis and septic shock according to Sepsis 3
Define sepsis and septic shock according to Sepsis 3
What is the management of sepsis?
What is the management of sepsis?
Study Notes
Shock and Its Types
- Shock is a life-threatening circulatory failure that results in cellular and tissue hypoxia.
- Hallmark sign: systolic blood pressure (SBP) less than 90 mmHg.
Types of Shock
- Distributive Shock: characterized by maldistribution of circulation, often due to vasodilation.
- Hypovolemic Shock: reduction in circulating blood volume due to hemorrhage or non-hemorrhagic causes.
- Cardiogenic Shock: characterized by pump failure and impaired contractility, with subtypes including cardiomyopathy, arrhythmias, and mechanical causes.
- Obstructive Shock: blockage of circulation to the tissues by impedance of outflow or filling in the heart, with subtypes including pulmonary embolism, pericardial tamponade, and tension pneumothorax.
- Septic Shock: a subset of sepsis with circulatory, cellular, and metabolic alterations associated with higher mortality.
- Neurogenic Shock: occurs in the presence of acute spinal cord injury above T6, resulting in inhibited sympathetic outflow and dominance of the parasympathetic nervous system.
- Anaphylactic Shock: a severe, whole-body allergic reaction triggered by exposure to an allergen.
Causes and Management of Shock
- Causes: cardiac output problem, vasodilation, and maldistribution of circulation.
- Management: initial assessment and hemodynamic monitoring, supportive care, and directed therapies targeting the underlying cause.
- Therapy aims to maintain oxygen delivery to vital organs and prevent ischemia and cell death.
Treatment of Shock
- Fluid resuscitation follows CRISTAL research and National Institute for Health and Care Excellence (NICE) guidelines, with consideration of Surviving Sepsis Campaign guidelines for septic shock.
- Vasoactive medications are used for vasoconstriction, vasodilation, and increased contractility.
- ‘FASTHUG’ mnemonic:
- Feeding: prevent malnutrition, promote adequate caloric intake
- Analgesia: reduce pain; improve physical and psychological wellbeing
- Sedation: titrate to the 3Cs – calm, cooperative, comfortable
- Thromboembolic prophylaxis: prevent deep vein thrombosis
- Head elevation: elevate head of bed to 30-45 degrees
- Upright: sit upright to improve oxygenation
Circulatory Failure in Shock
- Blood flow to tissues is not enough to maintain metabolic function, leading to an imbalance of oxygen supply and demand, resulting in hypoxia at the cellular level.
- Shock is not just about hypoxemia (low oxygen in the blood), but about hypoxia (low oxygen in the cells).
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