Shock

Question 1

cardiogenic shock

Answer 1

• inadequate tissue perfusion due to pump failure (most common anterior wall MI)

-tachypnea, crackles, pulmonary edema, S3 heart sounds

• treat with oxygenation, decrease preload with ntg, decrease afterload with ntg, increase contractility

Question 2

causes of obstructive shock

Answer 2

• resistance ventricular filling from pericardial tamponade
• tension pneumo
• PE
• supine vena cava syndrome in pregnancy
• abdominal compartment syndrome

Question 3

treatment of cardiogenic shock

Answer 3

• pericardiocentesis
• needle decompression or chest tube
• thrombolytics for PE
  -turn pregnant patients

Question 4

treatment for hypovolemic shock

Answer 4

• stop the bleed with direct pressure (tourniquets & pelvic binder)
• transfuse blood products 1:1:1 (do not dilute with NS)

-hypocalcemia is common in MTP so give calcium

-allow permissive hypotension with blunt abdominal trauma & pelvic fx to reduce bleeding

Question 5

lethal triad commonly seen in hypovolemic shock

Answer 5

hypothermia

acidosis

coagulopathy

Question 6

3 examples of distributive shock

Answer 6

-anaphylatic (think vasodilation)

-neurogenic (think brady & hypo)

-septic