Shock
Quiz yourself by thinking what should be in
each of the black spaces below before clicking
on it to display the answer.
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| show | A state of inadequate organ perfusion and tissue oxygenation.
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| Give four causes of shock, with the most common listed first | show 🗑
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| show | Hypotension without tachycardia or vasoconstriction (low, low, open)
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| What percentage of blood is in the venous system? | show 🗑
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| show | Tachycardia
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| The initial step in managing shock in injured patients is to | show 🗑
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| show | identify the probable cause of the shock state
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| show | the mechanism of injury
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| How does tension pneumothorax produce shock? | show 🗑
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| show | isolated brain injuries
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| Neurogenic shock results from extensive injury to | show 🗑
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| Spinal cord injury causes shock via | show 🗑
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| show | arrival at ER has been delayed by many hours
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| What is the most common cause of shock in the injured patient? | show 🗑
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| show | CO = HR x SV
L/min = beats/min x cc/beat / 1000
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| Stroke Volume (SV) is determined by what three factors? | show 🗑
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| Preload is determined by what three factors? | show 🗑
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| Volume of venous blood returned to heart determines | show 🗑
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| Myocardial contractility is | show 🗑
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| show | systemic (peripheral) vascular resistance to the forward flow of blood
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| Progressive vasoconstriction of ___ ___ ___ preserves blood flow to the ___ ___ ___. | show 🗑
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| show | increase in HR to preserve CO
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| Endogenous catecholamines increases | show 🗑
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| Increased peripheral vascular resistance increases ____ and decreases ____ and does ____. | show 🗑
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| Restore venous return to normal by ____ | show 🗑
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| show | anaerobic
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| Anaerobic metabolism leads to (2) | show 🗑
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| Steps in cellular death (7) | show 🗑
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| What helps combat cell death? | show 🗑
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| Three things to do in shock resuscitation | show 🗑
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| Goals in treatment of hemorrhagic shock (2) | show 🗑
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| show | vasopressors
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| Most injured patients with hypovolemic shock | show 🗑
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| show | 1-hemorrhagic
2-non-hemorrhagic
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| show | 1-pulse rate
2-respiratory rate
3-skin circulation
4-pulse pressure
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| show | tachycardia and cutaneous vasoconstriction
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| show | in shock until proven otherwise
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| show | > 160
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| show | > 140
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| Tachycardia in children from school age to puberty | show 🗑
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| show | > 100
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| Elderly patients may not exhibit tachycardia in shock because of (3) | show 🗑
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| Hg and Hct for estimating acute blood loss | show 🗑
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| show | identify and stop hemorrhage promptly
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| show | 1-cardiogenic shock
2-cardiac tamponade
3-tension pneumothorax
4-neurogenic shock
5-septic shock
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| show | 1-blunt cardiac injury
2-cardiac tamponade
3-air embolus
4-myocardial infarction
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| show | rapid deceleration
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| Cardiac tamponade and pericardial fluid can be determined by | show 🗑
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| Four signs of Cardiac Tamponade | show 🗑
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| show | needle decompression
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| show | 1-thoracotomy
2-pericardiocentesis (temporary)
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| Prevents return of air to lung in tension pneumothorax | show 🗑
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| How can spinal cord injury cause shock? | show 🗑
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| show | hypotension without (1) tachycardia or (2) cutaneous vasoconstriction
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| What do you not see with neurogenic shock? | show 🗑
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| Septic shock may occur in patients with | show 🗑
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| Hemorrhage is defined as | show 🗑
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| Normal adult blood volume percent of body weight | show 🗑
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| 70 kg male has circulating blood volume of approximately | show 🗑
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| show | based on ideal weight
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| show | 8 to 9% of body weight (80-90 mL/kg)
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| Volume replacement is guided by | show 🗑
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| Class I hemorrhage characterstics | show 🗑
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| Class II hemorrhage characterstics | show 🗑
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| show | complicated, requiring crystalloid infusion and, perhaps, blood
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| show | preterminal, patient will die within minutes
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| show | I up to 750
II 750-1500
III 1500-2000
IV > 2000
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| Blood loss (%) in hemorrhage classes | show 🗑
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| Pulse rate in hemorrhage classes | show 🗑
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| Blood pressure in hemorrhage classes | show 🗑
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| Pulse pressure in hemorrhage classes | show 🗑
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| Respiratory rate in hemorrhage classes | show 🗑
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| Urine output (mL/hr) in hemorrhage classes | show 🗑
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| CNS/Mental state in hemorrhage classes | show 🗑
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| show | I crystalloid
II crystalloid
III crystalloid and blood
IV crystalloid and blood
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| Fractured tibia or humerus blood loss may be | show 🗑
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| Fractured femur blood loss may be | show 🗑
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| show | up to several liters
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| show | 1-persistent blood loss 2-unrecognized fluid losses or 3-nonhemorrhagic shock
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| How do major soft tissue injuries and fractures compromise hemodynamics? | show 🗑
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| show | plasma into extravascular, extracellular space
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| show | depletion of intravascular volume
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| show | the diagnosis and treatment
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| Three important factors in physical exam in shock | show 🗑
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| Priorities for circulation in shock (3) | show 🗑
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| When undressing the patient, it is essential to | show 🗑
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| show | 1-unexplained hypotention 2-cardiac dysrhythmia (bradycardia from vagal stimulation)
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| Unconscious with gastric distenstion | show 🗑
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| show | does not
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| Bladder catheterization used for (2) | show 🗑
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| show | rate of flow proportional to the fourth power of radius of cannula, and inversely related to length
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| show | forearms and antecubital veins
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| Central lines second best IV access location | show 🗑
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| Central line techniques (2) | show 🗑
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| show | sterile, and should be changed
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| Priority of IV access in kids under 6 | show 🗑
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| Determinant for selecting proper IV access | show 🗑
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| show | CXR
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| Usual fluid bolus | show 🗑
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| show | 3-for-1 rule
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| Goal of resuscitation in shock | show 🗑
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| show | increased bleeding may occur
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| Fluid consideration in blunt trauma | show 🗑
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| show | control bleeding
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| Fluid resuscitation with continued bleeding referred to as (4) | show 🗑
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| Signs suggesting perfusion is returning to normal | show 🗑
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| Indicator of renal perfusion | show 🗑
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| show | respiratory alkolosis due to tachypnea
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| show | severe metabolic acidosis due to anaerobic metabolism
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| What should not be used for metabolic acidosis secondary to hypovolemic shock? | show 🗑
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| Key determinant of subsequent therapy | show 🗑
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| show | 1-stable: persistent tachycardia, tachypnea, and oliguria, underresuscitated and still inshock 2-normal: no signs of inadequate tissue perfusion
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| show | 1-rapid 2-transient 3-minimal or no
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| show | restore oxygen-carrying capacity of intravascular volume
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| Blood product priority | show 🗑
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| Blood for transient responders | show 🗑
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| Blood for rapid responders | show 🗑
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| Can be warmed in microwave | show 🗑
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| Can not be warmed in microwave | show 🗑
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| How do you warm blood? | show 🗑
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| show | autotransfusion
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| Most patient receiving blood transfusion ____require calcium supplementation. | show 🗑
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| Ohm's Law | show 🗑
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| show | should not be
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| Elderly decrease in sympathetic activity | show 🗑
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| show | early invasive monitoring
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| show | may increase 15 to 20%
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| Cardiac output in athlete | show 🗑
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| SV in athlete | show 🗑
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| Resting pulse in athlete can average | show 🗑
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| Intoxicated trauma patient may have hypothermia due to | show 🗑
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| Hypothermia is best treated by | show 🗑
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| Most common complication of treating hemorrhagic shock | show 🗑
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| show | obscure hemorrhage
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| show | superior vena cava just proximal to RA
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| show | 1-infection 2-vascular injury 3-nerve injury 4-embolization 5-thrombosis 6-pneumothorax
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| show | right heart function
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| Consider when patient fails to respond to therapy in shock | show 🗑
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| show | hypovolemic
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| Basic management principle, again, in shock | show 🗑
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Created by:
tcrouch2000
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