Shock: Understanding Types and Management

These flashcards cover essential concepts related to shock, including its definition, types, stages, and management strategies.

What is Shock?

A life-threatening state characterized by inadequate tissue perfusion, leading to insufficient oxygen and nutrient delivery to vital organs.

Hypovolemic Shock

A type of shock resulting from decreased intravascular volume due to fluid loss, especially from hemorrhage.

Cardiogenic Shock

A state resulting from the impairment or failure of the myocardium, commonly following a myocardial infarction.

Septic Shock

Circulatory shock resulting from overwhelming infection leading to relative hypovolemia.

Neurogenic Shock

Shock caused by the loss of sympathetic tone, resulting in relative hypovolemia, typically following traumatic brain injury or spinal cord injury.

Anaphylactic Shock

A severe allergic reaction causing systemic vasodilation and relative hypovolemia.

Obstructive Shock

A type of shock caused by physical obstruction of blood flow, such as pulmonary embolism or tension pneumothorax.

Compensatory Stage of Shock

The initial stage of shock where the body attempts to maintain perfusion through sympathetic nervous system responses.

sympathetic nervous system tries to overcome decreased tissue perfusion by triggering 

vasoconstriction 

sympathetic nervous system stimulates increase in 

heart rate and contractility resulting in temporarily normal bp and cardiac output.

sympathetic nervous system activate catecholamines to assist with

vasoconstriction and glucose to meet metabolic demands energy production during shock.

sympathetic nervous system body shuts blood away from _______ and towards_____

away from skin, GI, and kidneys towards the brain, heart and lungs

RAAS system

retains water and sodium which decreases urine output

hypoxia will cause 

anaerobic metabolism 

anaerobic metabolism from hypoxia increases

lactic acid and can cause metabolic acidosis

Progressive Stage of Shock

2nd stage where compensatory mechanisms fail, leading to decreased blood pressure and organ hypoperfusion.

what happens to mental status during progressive stage 

deteriorates from decreased blood flow to the brain and will become unresponsive 

what happens to the lungs during progressive stage

decreased pulmonary blood flow

increased CO2 levels

labored or irregular breathing

pulmonary edema occurs

resulting in intubation

what happens to the heart during progressive stage

decreased cardiac output, arrhythmias, and elevated heart rate due to reduced blood volume.

what happens to the kidneys during progressive stage

decreased renal perfusion, leading to reduced urine output (oliguria) and potential acute kidney injury.

Irreversible Stage of Shock (Refractory Stage)

The point at which shock is deemed irreversible, often resulting in multiple organ dysfunction syndrome and high mortality.

DIC (Disseminated Intravascular Coagulation)

A condition characterized by massive activation and consumption of coagulation proteins, often seen in septic shock.

simultaneously bleeding and clotting at the same time 

what do you watch for if a pt is suspected to have DIC

Signs of bleeding and thrombosis, including petechiae, hematuria, or prolonged bleeding from puncture sites.

labs: platelets, PT, and aPTT

DIC treatment

fresh frozen plasma

plasmaphoresis

fibrinogen

Vasoactive Medications

norepinephrine

epi 

vasopressin 

phenylephrine 

inotropes

dopamine 

dobutamine 

milrinone 

Fluid Replacement Therapy

An essential management strategy in shock to restore intravascular volume using crystalloid or colloid solutions.

what can you do to manage shock

fluid replacement therapy

passive leg raise

vasoactive medications

nutritional support 

inotropes 

if a pt is in the irreversible stage of shock what is their ABG

serve metabolic acidosis 

what is the ABG of the compensatory stage

respiratory alkaolsis

skin during compensatory stage

cool and clammy

cap refill less than 3.5 secs

RR during comp stage 

rapid 

RR during progressive stage

shallow and rapid

crackles