chadbourne shock and sirs

What is Systemic Inflammatory Response Syndrome (SIRS)?

Overwhelming inflammatory reaction due to trauma.

What are key criteria for SIRS?

Tachycardia (>90 BPM), tachypnea (>20 breaths/min), hyperthermia/hypothermia, leukocytosis (>12K WBC), leukopenia (<4K WBC).

What happens to GI and urine output in SIRS?

Reduced.

What hormones increase in SIRS?

Catecholamines.

What is a major immune effect of SIRS?

Immunosuppression.

What does CARS stand for?

Compensatory Anti-inflammatory Response Syndrome.

When does CARS occur?

During a period of systemic infection.

What follows SIRS?

Sepsis.

What is severe sepsis associated with?

Organ failure, altered mental status, renal insufficiency, DIC, hypotension, hypoxemia.

What is the defining feature of septic shock?

Insufficient blood flow after organ failure.

What are symptoms of septic shock?

Low BP, rapid HR, pale skin, SOB, cold extremities.

How do IV fluids respond in septic shock?

No response.

What happens in the initial stage of shock?

Sudden drop in tissue perfusion, RAAS activation, increased HR.

What happens in the progressive stage of shock?

Decreased perfusion to lungs, kidneys, liver; cyanosis of extremities.

What happens in the irreversible stage of shock?

Myocardial and cerebral ischemia, widespread cellular hypoxia.

What is cardiogenic shock caused by?

Heart failure, MI, arrhythmias (V fib, A fib).

What are signs of cardiogenic shock?

Very anxious, hypotension, tachycardia.

What is cardiac tamponade?

Fluid accumulation around the heart causing backflow.

What are signs of cardiac tamponade?

Pulsus paradoxus, JVD, muffled heart sounds, hypotension.

What causes hypovolemic shock?

Blood loss, low venous return.

What are symptoms of hypovolemic shock?

Thirst, rapid HR.

What causes anaphylactic shock?

Severe allergic reaction.

What is the treatment for anaphylactic shock?

Epinephrine (EpiPen).

What causes neurogenic shock?

TBI or spinal injury.

What happens to blood vessels in neurogenic shock?

Vasodilation reduces venous return.

What happens to BP in neurogenic shock?

Low blood volume leads to low BP.

What is a unique symptom of neurogenic shock?

Bradycardia (due to excessive parasympathetic response).