Shock & Sepsis

These flashcards cover key vocabulary and concepts from the lecture notes on hypotension, shock, and sepsis.

What is shock?

inadequate tissue perfusion causing cellular and tissue hypoxia

What are the kinds of shock?

hypovolemic

cardiogenic

obstructive

distributive/vasodilatory

neurogenic

What determines tissue perfusion?

MAP

How can global perfusion be evaluated?

mental status

urine output

peripheral perfusion assessment

serum lactate levels/metabolic acidosis

What is compensated shock?

pre-shock

tachycardia, peripheral vasoconstriction, decreased BP

What is an arterial line?

placed into an artery for continuous BP monitoring, lab draws, and regular ABGs

Can medications be given in an arterial line?

no

What are the indications for a central venous catheter?

delivery of caustic or critical meds (vasopressors or inotropes)

administer meds or blood products

draw blood samples and monitor CVP

What are examples of central venous catheters?

triple lumen central line

dialysis catheter

Swan-Ganz catheter

PICC line

What is a normal CVP?

5-15mmHg

What is CVP?

indirect estimate of right atrial pressure

correlates preload or overall volume status

obtained with any central line

What is a normal PCWP?

5-15mmHg

What is a normal CO?

5-6 L/min

What is a normal SVR?

1000-1500

What is PCWP?

indirect estimate of left atrial pressure

correlates fluid status on left side of the heart

What PCWP indicates volume overload?

over 20

What hemodynamic monitoring is most appropriate in cardiogenic shock?

Swan-Ganz catheter

What clinical presentation is associated with all kinds of shock?

hypotension (NOT in neurogenic)

tachycardia and tachypnea

oliguria

mental status change

metabolic acidosis

cool and clammy skin

What findings indicate sepsis?

SIRS + source of infection

What findings indicate severe sepsis?

sepsis + end organ dysfunction

What findings indicate septic shock?

sepsis + refractory hypotension

+/- high lactate

What is the surviving sepsis campaign?

guideline for evaluation and management

recommends screening for all potentially infected seriously ill patients