Shock

Initial Stage of Shock

Blood loss of 750 ccs or 15% of total blood volume with minor decreases in MAP.

Nonprogressive Stage of Shock

Compensatory stage with 750 to 1500 ccs or 15% to 30% blood volume loss, MAP decreases by 10 to 15 mm Hg.

Progressive Stage of Shock

Sustained decrease in MAP of more than 20 mm Hg and 1500 to 2000 ccs or 30% to 40% blood volume loss.

Refractory Stage of Shock

More than 2 L of blood loss or greater than 40% of total blood volume leading to severe hypotension and lethargy.

Multiple Organ Dysfunction Syndrome (MODS)

A syndrome where metabolites from dead cells cause dysfunction in vital organs, starting with liver, heart, brain, and kidneys.

Hypovolemic Shock

Type of shock caused by a decrease in intravascular volume, leading to inadequate tissue perfusion.

Causes of Hypovolemic Shock

Includes hemorrhage, dehydration, fluid shifts, trauma, and burns.

Treatment for Hypovolemic Shock

Control blood loss, replace volume with colloids, crystalloids, and blood products.

Cardiogenic Shock

Shock resulting from the heart muscle's inability to pump effectively, often due to myocardial infarction.

Clinical Manifestations of Cardiogenic Shock

Tachycardia, decreased cardiac output, and narrowing pulse pressure.

Treatment of Cardiogenic Shock

Includes beta-adrenergic agonists such as norepinephrine and dobutamine.

Obstructive Shock

Shock that occurs due to mechanical obstruction preventing effective heart muscle pumping.

Causes of Obstructive Shock

Includes pulmonary embolism and cardiac tamponade.

Distributive Shock

Shock where blood volume is distributed abnormally in the vascular space, leading to relative hypovolemia.

Pathogenesis of Septic Shock

Characterized by capillary leaking leading to increased cardiac output and systemic inflammatory response.

Anaphylactic Shock

Shock caused by an antigen-antibody reaction leading to bronchoconstriction and peripheral vasodilation.

Treatment for Anaphylactic Shock

Includes airway management, bronchodilators, IV therapy with normal saline, and steroids.

Fluid Resuscitation in Septic Shock

Administering large volumes of intravenous fluids (usually crystalloids) to restore intravascular volume and improve tissue perfusion.

Antibiotic Therapy in Septic Shock

Initiating broad-spectrum antibiotics as soon as possible to combat the underlying infection causing septic shock.

Vasoactive Medications in Septic Shock

Using medications such as norepinephrine to maintain adequate blood pressure when fluid resuscitation is insufficient.

Initial Treatment for Obstructive Shock

Identify and treat the underlying cause such as relieving a pulmonary embolism or cardiac tamponade.

Surgical Intervention in Obstructive Shock

May be required for conditions like cardiac tamponade or tension pneumothorax to remove the obstruction.