AOSS chapter 13 - 14 flashcards

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Hypoperfused

a condition which describes inappropriate or decreased blood flow within an organ

circulatory system

a complex arrangement of connected tubes, including the arteries, arterioles, capillaries, venules, and veins in which blood circulates throughout the body

Systemic circulation

between the heart and the body

Pulmonary circulation

between the heart and the lungs

diffusion

a passive process in which molecules move from an area of higher concentration to an area of lower concentration.

Blood

Composed of red blood cells, white blood cells, platelets, and liquid called plasma

Red blood cells

responsible for transporting oxygen to the cells and transporting carbon dioxide away from the cells to the lungs, where it is exhaled and removed from the body

White blood cells

help fight infection

platelets

assist in forming blood clots

Plasma

contains electrolytes and fluid, which are important for cell to function

systolic pressure

peak arterial pressure, or pressure generated when the heart conftracts

diastolic pressure

pressure maintained within the arteries while the heart is at rest

hormones and autonomic nervous system

responsible for the flight-fight response, assumes more control of the body’s function during a state of shock.

epinephrine and norepinephrine

neurotransmitters and hormones, cause changes in certain body functions, including an increase in the heart and the strength of cardiac contractions.

peripheral vasoconstriction

reducing blood flow to the skin, also helps shunt blood to the vital organs

Pump failure

Causes: heat attack, trauma to heart, obstructive causes (large pulmonary embolus)

Low fluid volume

Causes: Trauma to vessels or tissues, fluid loss from GI tract (vomiting/diarrhea can also lower the fluid component of blood)

Poor vessel function

Causes: infection, drug overdose (narcotic) spinal cord injury, anaphylaxis

Tachypnea

Rapid respirations

crackles

a rattling sound that may be head during breathing, typically on inhalations

Cardiogenic shock

develops when the heart cannot maintain sufficient output

Cardiac output

the volume of blood that the heart can pump per minute and depends on several factors.

Three most common examples of obstructive shock

Cardiac tamponade, tension pneumothorax, and pulmonary embolism

pericardium

tough fibrous membrane of the heart

pericardial sac

outer walls of the heart

Signs and symptoms of cardiac tamponade

referred to as the beck triad: the presence of jugular vein distention, muffled heart sounds, and narrowing pulse pressure, where the systolic and diastolic blood pressures start to merge.

tracheal deviation

your trachea is pushed to one side of your neck by abnormal pressure in your chest cavity or neck, a late sign of tension pneumothorax

pneumothorax

A collapsed lung that occurs when air enters into the pleural cavity, the space around lungs. This causes pain in the chest and difficulty in breathing.

The four most common types of distributive shock

Septic shock, neurogenic shock, anaphylactic shock, and pstchogenic shock

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hypovolemia

A condition in which the volume of blood plasma is too low. This causes rapid heart beat, weak pulse, confusion and loss of consciousness.

vascular volume

blood volume

vasodilation

the dilatation of blood vessels, which decreases blood pressure.

four most common allergic reactions

Injections, stings, ingestion, inhaltation

expect shock from patients who have:

* Multiple several fractures
* Abdominal or chest injury
* Spinal injury
* Severe infection
* Major heart attack
* Anaphylaxis

Hemorrhage

an escape of blood from a ruptured blood vessel, bleeding

Anticoagulants

Can increase bleeding and worsen shock.

Beta blockers

can prevent the heart rate from rising to compensate for shock

sphygmomanometer

blood pressure cuff

nitroglycerin

patients in cardiogenic shock should not receive.

Treating obstructive shock

Dependent on cause:

* ALS assist and/or rapid transport. Administer high flow oxygen.

Treating cardiogenic shock

Position comfortably. Administer high-flow oxygen, Assist ventilations, transport promptly. Consider ALS

Treating Septic shock

Transport promptly, administer high-flow oxygen, assist ventilations, keep patient warm, consider ALS.

Treating Neurogenic shock

Secure airway, spinal immobilization, assist ventilations, administer high flow oxygen, preserve body heat, transport promptly, Consider ALS.

Treating Anaphylactic shock

Manage the airway, assist ventilation, administer high-flow oxygen, determine cause, assist with administration of epinephrine, transport promptly, consider ALS.

Treating psychogenic shock

Determine duration of unconsciousness, position the patient supine, record initial vital signs and mental status, suspect head injury if patient is confused or slow to regain consciousness, transport promptly.

Treating Hypovolemic shock

Secure airway, assist ventilation, administer high-flow oxygen, control external bleeding, keep warm, transport promptly, consider ALS

Signs of compensated shock

anxiety or agitation; increased respiratory rate; nausea and vomiting; and increased thirst.

Signs of decompensate shock

labored or irregular respiration, ashen gray or cyanotic skin color, weak or absent distal pulses, dilated pupils, and profound hypotension (systolic blood pressure if 90 mm Hg or lower in an adult)

Treat all patients suspected to be in shock from any cause as follows and in this order

1. Open and maintain the airway.
2. Control life-threatening hemorrhage immediately with direct pressure or tourniquet application when appropriate.
3. Provide high-flow oxygen, and as needed, provide bag-ask-assisted ventilations.
4. Maintain normal body temperature with blankets.
5. provide calm reassurance.
6. provide prompt transport to the appropriate hospital

after load

The force or resistance against which the heart pumps

anaphylactic shock

Severa shock caused by allergic reaction

anaphylaxis

an extreme, life-threatening, systemic allergic reaction that may include shock and respiratory failure

aneurysm

a swelling or enlargement of a part of an artery, resulting from weakening of the arterial wall

Autonomic nervous system

The part of the nervous system that regulates involuntary activities of the body, such as heart rate, blood pressure and digestion of food.

cardiac tamponade

compression of the heart as the result of buildup of blood or other fluid in the pericardial sac, leading to decreased cardiac output.

cardiogenic shock

a state in which not enough oxygen is delivered to the tissues of the body, caused by low output of blood the heart.

compensate shock

The early stage of shock, in which the body can still compensate for blood loss.

cyanosis

a blue skin discoloration that is caused by a reduced level of oxygen in the blood.

decompensated shock

The late stage of shock when blood pressure is falling

dehydration

loss of water from the tissues of the body

distributive shock

a condition that occurs when there is widespread dilation of the small arterioles, small venules, or both

edema

the presence of abnormally large amounts of fluid between cells in body tissues causing swelling of the affected are area.

homeostasis

A balance of all systems of the body

hypothermia

a condition in which the internal body temperature falls below 95F (35C)

hypovolemic shock

a condition in which low blood volume, due to massive internal or external bleeding or extensive loss of body water.

irreversible shock

a condition defined by the inability to successfully achieve resuscitation regardless of the methods employed

myocardial contractility

the ability of the heart muscle to contract

neurogenic shock

circulatory failure caused by paralysis of the nerves that control the size of the blood vessels, leading to widespread dilation; seen in patients with spinal cord injuries.

obstructive shock

shock that occurs when there is a blood-to-blood flow in the heart or great vessels, causing an insufficient blood supply to the body’s tissues.

perfusion

the flow of blood through body tissues and vessels.

pericardial effusion

a collection of fluid between the pericardial sac and the myocardium

preload

the precontraction pressure in the heart as the volume of blood builds up.

psychogenic shock

Shock caused by a sudden, temporary reduction in blood supply to the brain that causes fainting (syncope).

pulmonary embolism

a blood clot that breaks off from a large vein and travels to the blood vessels of the lung, causing obstruction of blood flow

pulse pressure

the difference between the systolic and diastolic pressures

sensitization

developing a sensitivity to a substance that initially caused no allergic reaction.

septic shock

shock caused by severe infection usually a bacterial infection.

shock

a condition in which the circulatory systems fail to provide sufficient circulation to maintain normal cellular functions; also called hypoperfusion.

sphincters

muscles that encircle and, by contracting, constrict a duct, tube or opening.

syncope

a fainting spell or transient loss of consciousness.

capillary sphincters

the capillary beds is regulated by.

infection

common cause of obstructive shock

hemoglobin

molecule that is the primary carrier of oxygen in the bloodstream

cervical spine

Neurogenic shock usually results from damage to the spinal cord at the:

low circulating blood volume

hypovolemic shock is the result of:

signs of anaphylactic shock

* can develop within seconds.
* Mild itching or rash
* Burning skin
* Vascular dilation
* Generalized edema.
* Coma
* Rapid death

signs of cardiogenic shock

* Chest pain
* Irregular pulse
* Weak pulse
* Low blood pressure
* Cyanosis (lip, under nails)
* Cool, clammy skin
* Anxiety
* Crackles (rales)
* Pulmonary edema

Signs of hypovolemic shock

* Rapid, weak pulse
* Low Blood pressure
* Change in mental status.
* Cyanosis (lips, under mails)
* Cool, clammy skin increased respiratory rate.

signs of neurogenic shock

* Bradycardia (slow pulse
* Low Blood pressure
* Signs of neck injury

signs of psychogenic shock

* Rapid pulse
* Normal or low blood pressure

Signs of septic shock

* Warm skin or fever
* Tachycardia
* Low blood pressure

abdominal thrust maneuver

the preferred method to dislodge a severe airway obstruction in adults and children; also called the Heimlich maneuver.

Active compression-decompression CPR

A technique that involves compressing the chest and then actively pulling it back up to its neutral position or beyond (decompression); may increase the amount of blood that returns to the heart and, thus, the amount of blood ejected from the heart during the compression phrase.

Advanced life support (ALS)

Advanced life-saving procedures, some of which are now being provided by the EMT.

Basic Life support (BLS)

Noninvasive emergency life-saving care that is used to treat medical conditions, including airway obstruction, respiratory arrest, and cardiac arrest

Cardiopulmonary resuscitation (CPR)

The combination of chest compressions and rescue breathing used to establish adequate ventilation and circulation in a patient who is not breathing and has no pulse.

Chest compression fraction

The total percentage of time during a resuscitation attempt in which active chest compressions are being preformed.

Dependent lividity

Blood settling to the lowest point of the body, causing discoloration of the skin; a definitive sign of death

Gastric distention

a condition in which air fills the stomach, often as a result of high volume and pressure during artificial ventilation.

hyperventilation

Rapid or deep breathing that lowers the blood carbon dioxide level below normal; may lead to increased intrathoracic pressure, decreased venous return, and hypotension when associated with bag-mask device use.