Shock

Question 1

Anaphylactic Shock

Answer 1

Massive vasodilation
caused by release
of histamines in
response to allergic
reaction

Cause: IV contrast, drugs
(ASA, insect bites
or stings,
anesthetic agents,
vaccines, foods,
materials (latex)

Medication: histamine H2
blockers (Tagamet®),
Epinephrine (drug of
choice), Benedryl®,
Volume expanders,
Solumedrol®,
brochodilators. Ensure
patent airway, oxygen.

Question 2

Hypovolemic Shock

Answer 2

Loss of intravascular
volume, decrease
stroke volume, and
decrease cardiac
output

3rd spacing,
diuresis,
Hemorrhage (#1
cause), burns, GI
fluid loss (vomiting,
diarrhea, drainage
from NG tube), DI,
DKA, Addison’s
disease.

Medication: Levophed®
Neo-Synephrine®,
Intropin®, Pitressin®
Rapid volume replacement
(blood, isotonic solutions),
control bleeding, oxygen,
hemodynamic monitoring.

Question 3

Cardiogenic Shock

Answer 3

Cardiogenic shock Inability of heart to pump blood out
effectively (pump failure), resulting in decrease cardiac
output

Myocardial infarction, lethal
ventricular arrhythmias, Endstage heart failure.

Medication: Dobutamine®
Dopamine®, Epinephrine®,
Primacor®, Nitroglycerin®,
Nipride®, Morphine®,
intra-aortic balloon pump
(IABP), correct arrythmias,
oxygen, Intubation &
mechanical ventilation may
be necessary.

Question 4

Septic shock

Answer 4

Massive vasodilation
caused by inflammatory
response of body due to overwhelming infection

Sepsis caused by
any pathogenic
organism that
invades the body

Antimicrobial therapy,
volume replacement,
cultures, vasopressors,
hemodynamic monitoring.

Question 5

Neurogenic shock

Answer 5

Pooling of blood -decrease venous return, decrease
cardiac output, hypotension, bradycardia

Massive vasodilation,
suppression of the
sympathetic nervous system,
injury/disease to the spinal cord at T6, spinal
anesthesia.

Treat the cause,
vasopressors, airway and
ventilation support.