Shock

Question 1

Definition of shock

Answer 1

Circulatory failure resulting in tissue hypoperfusion and end-organ damage. Often definied by low BP (SBP <90, MAP<65).

Question 2

Global Sx and signs of shock

Answer 2

• weak and rapid pulse
• pale and cold, clammy skin
• reduced UO
• confusion
• weakness
• collapse
• coma

Question 3

Types of shock

Answer 3

1. Hypovolemic: haemorrhage, loss of body fluids, burns
2. Cardiogenic: MI, arrhythmias, pump failure
3. Obstructive: cardiac tamponade (impaired diastolic filling), PE (increased ventricular afterload), tension pneumothorax (obstruction of venous return)
4. Distributive: septic (capillary leakage), anaphylactic, neurogenic (vascular tone dysregulation)

Question 4

Tx for septic shock

Answer 4

Avoid triggers
ABCDE
Adrenaline IM
salbutamol
IV clorphenamine - antihistamine
IV hydrocortisone - steroid to decrease inflammation

Question 5

Tx for hypovolaemic shock

Answer 5

ABCDE
Raise legs
Fluid bolus
If haemorrhagic: crossmatch, give fresh frozen plasma alongside packed red cells (1:1 ratio)

Question 6

What can be used to increase HR in cardiogenic shock?

Answer 6

Dobutamine

Question 7

What is the Sx triad for neurogenic shock?

Answer 7

hypotension, bardycardia, peripheral vasodilation

+hypothermia

Question 8

Injury above what level can cause neurogenic shock?

Answer 8

Above T6

Question 9

What is Sepsis 6?

Answer 9

Give 3, Take 3 (BUFALO)

Take Bloods, UO, Lactate

Give Fluids, Abx and Oxygen