Notes in 05 Shock

To Subscribe, use this Key

Status	Last Update	Fields
Published	07/30/2024	Three Phases of Shock:{{c1::1. Compensated2. Decompensation3. Irreversible}}
Published	07/30/2024	Major Baroreceptors can be found in these 3 places:{{c1::Atrial heart wallAortic ArchCarotid Sinuses}}
Published	07/30/2024	What happens next?1. Normal Intravascular Volume2. {{c1::↑::↑/↓}} Baroreceptor Signals3. {{c1::↓::↑/↓}} SNS activation of brainstem vasomotor centers
Published	07/30/2024	What happens next?1. ↓ Intravascular Volume2. {{c1::↓::↑/↓}} Baroreceptor Signals3. {{c1::↑::↑/↓}} SNS activation of brainstem vasomotor centers
Published	07/30/2024	Major Chemoreceptors can be found in these 2 places:{{c1::Aortic ArchCarotid Bodies}}
Published	07/30/2024	The CVD response to shock involves the activation of {{c1::beta-1}} receptors to increase HR and contractility
Published	07/30/2024	The CVD response to shock involves the activation of {{c1::alpha-1}} receptors to increase vasoconstriction
Published	07/30/2024	The hormonal response to shock involves the release/activation of 3 important hormones:{{c1::CRH (→ ACTH → cortisol)Renin (→ AT2)ADH}}
Published	07/30/2024	These 3 hormones act syngergistically to induce a catabolic state in response to shock:{{c1::CortisolEGlucagon}}
Published	07/30/2024	[VR] In the setting of severe hypovolemia1. Cortisol2. ACTH{{c1::C}}
Published	07/30/2024	Why does ADH stay elevated for 1 week after shock?{{c1::It really depends on severity, but E, AT2, pain, and hyperglycemia all contribute to ↑ ADH}}
Published	07/30/2024	{{c1::ADH::hormone}} acts as a potent mesenteric vasoconstrictor, shunting circulating blood away from the splanchnic organs during hypovolemia
Published	07/30/2024	Px on chronic therapy with {{c1::ACE inhibitors::medication}} are more at risk of developing hypotension and vasodilatory shock with open heart surger…
Published	07/30/2024	Shock General Clinical Findings:{{c1::Weak/Absent peripheral pulsesAgitationCool clammy extremitiesTachycardiaHypotension}}
Published	07/30/2024	Hemorrhage Class {{c1::I}}Blood Loss: {{c2::<750 mL or <15%::mL and %}}Usually HR: {{c1::Normal}}CNS Symptoms: {{c1::Normal}}
Published	07/30/2024	Hemorrhage Class {{c1::II}}Blood Loss: {{c2::750-1500 mL or 15-30%::mL and %}}Usually HR: {{c1::>100}}CNS Symptoms: {{c1::Anxious}}
Published	07/30/2024	Hemorrhage Class {{c1::IV}}Blood Loss: {{c2::>2000 mL or >40%::mL and %}}Usually HR: {{c1::>140}}CNS Symptoms: {{c1::Obtunded}}
Published	07/30/2024	For Px undergoing hemorrhage, a BP of <{{c1::110}} mmHg is a clinically relevant definition of hypotension and hypoperfusion
Published	07/30/2024	Blood tests or Markers for px with hemorrhage for estimation and monitoring of extent of bleeding and shock:{{c1::Serum LactateBase Deficit::2}}
Published	07/30/2024	Base Deficit Category ValuesMild: {{c1::-3 to -5}} mmol/LModerate: {{c1::-6 to -9}} mmol/LSevere: {{c1::-10}} mmol/L
Published	07/30/2024	In the nontrauma patient, {{c1::the GI tract}} must always be considered as a site for blood loss
Published	07/30/2024	Each pleural cavity can hold {{c1::2-3}} L of blood and can therefore be a site of significant blood loss
Published	07/30/2024	What to do immediately in px experiencing hemorrhagic shock:{{c1::1. Secure Airway2. Blood loss control3. Circulation (IV volume resucitation)::3}}
Published	07/30/2024	When a hemorrhaging px is rapidly deteriorating while source of blood loss is being located, keep the SBP to {{c1::80-90}} mmHgIf this px is hemorrhag…
Published	07/30/2024	Fluid Resucitation Fluid of Choice: {{c1::Crystalloids::Fluid Class}}
Published	07/30/2024	Fluid Resucitation in Px with Severe Hemorrhage Fluid of Choice: {{c1::Blood Products::Fluid Class}}
Published	07/30/2024	Fluid Resucitation in Px with Combat Injuries and Inflammation Fluid of Choice: {{c1::Hypertonic Saline::Fluid Class}}
Published	07/30/2024	Traumatic Shock from blunt trauma often leads to the following complications:{{c1::Multiple Organ Failure (MOS)Acute Respiratory Distress Syndrome (AR…
Published	07/30/2024	{{c1::Traumatic}} Shock - Soft tissue injury, long bone fractures, and blood loss
Published	07/30/2024	{{c1::Vasodilatory}} Shock - Final common pathway for profound and prolonged shockof any etiology
Published	07/30/2024	The most common form of vasodilatory shock is {{c1::septic}} shock
Published	07/30/2024	In septic shock, the vasodilatory effects are due, in part, to the upregulation of the {{c1::inducible isoform of nitric oxide synthase (iNOS or NOS 2…
Published	07/30/2024	For px with septic shock, fluid resuscitation should begin within the first hour and should be at least {{c1::30}} mL/kg for hypotensive patients
Published	07/30/2024	First-line vassopressors: {{c1::NE then E}}
Published	07/30/2024	First-line vassopressors in a px w/ arterial resistance to catecholamines: {{c1::ADH and NE}}
Published	07/30/2024	When shock occurs in the presence of hyperglycemia and insulin resistance, think of {{c1::septic}} shock
Published	07/30/2024	Cardiogenic Shock Diagnosis:{{c1::1. SBP <90 mmHg for at least 30 min2. Reduced cardiac index of <2.2 L/min/sqm3. Elevated pulmonary artery wedg…
Published	07/30/2024	The most common cause of cardiogenic shock is {{c1::MI}}
Published	07/30/2024	Cardiogenic Shock Diagnosis:{{c1::ECG & ECHO::Gold Standard/s}}{{c1::Depressed mental status::Mental Status}}HypotensionCool and mottled skinTachy…
Published	07/30/2024	Common electrolyte abnormalities one should think about in the setting of cardiogenic shock are {{c1::hypokalemia and hypomagnesemia}}
Published	07/30/2024	{{c1::Neurogenic}} shock - Diminished tissue perfusion as a result of loss of vasomotor tone to peripheral arterial beds usually secondary to spinal c…
Published	07/30/2024	First-line vassopressors in a px w/ neurogenic shock: {{c1::Dopamine}}
Published	07/30/2024	Second-line vassopressors in a px w/ neurogenic shock: {{c1::Phenylephrine}}
Published	07/30/2024	The most common cause of obstructive shock is {{c1::tension pneumothorax}}
Published	07/30/2024	The major determinant of the degree of hypotension is obstructive shock is {{c1::the pericardial pressure}}
Published	07/30/2024	Most recommended placement of chest thoracotomy tube for tension pneumothorax: {{c1::4th ICS, AAL}}
Published	07/30/2024	{{c2::Cardiac Tamponade}} Clinical Findings:{{c1::Beck's Triad:HypotensionMuffled heart tonesNeck vein distention}}
Published	07/30/2024	Cardiac Tamponade Diagnosis: {{c1::ECHO::gold standard}}
Published	07/30/2024	All forms of shock have {{c1::↑::↑/↓/=}} RR
Published	07/30/2024	All forms of shock have ↑ HR, except for {{c1::neurogenic}} shock
Published	07/30/2024	All forms of shock have cool skin, except for {{c1::septic and neurogenic}} shock
Published	07/30/2024	{{c1::Septic}} shock manifests with flushed skin → cool, pale skin{{c1::Neurogenic}} shock manifests with persistent warm flushed and dry skin
Published	07/30/2024	All forms of shock have oliguria but {{c1::neurogenic}} shock has variable bladder control
Published	07/30/2024	[VR]1. Hypovolemic/Hemorrhagic Shock2.1 Cardiac Index2.2 Systemic Vascular Resistance (SVR)2.3 Venous Capacitance2.4 Central Venous Pressure (CVP) &am…
Published	07/30/2024	[VR]1. Vasodilatory/Septic Shock2.1 Cardiac Index2.2 Systemic Vascular Resistance (SVR)2.3 Venous Capacitance2.4 Central Venous Pressure (CVP) & P…
Published	07/30/2024	[VR]1. Cardiogenic Shock2.1 Cardiac Index2.2 Systemic Vascular Resistance (SVR)2.3 Venous Capacitance2.4 Central Venous Pressure (CVP) & Pulmonary…
Published	07/30/2024	[VR]1. Neurogenic Shock2.1 Cardiac Index2.2 Systemic Vascular Resistance (SVR)2.3 Venous Capacitance2.4 Central Venous Pressure (CVP) & Pulmonary …
Published	07/30/2024	Lactate should be normalized within {{c1::24 hours::timeframe}}
Published	07/30/2024	If base deficit persists, what do you think is happening?{{c1::Ongoing bleeding}}
Published	07/30/2024	Near infrared (NIR) spectroscopy can measure tissue oxygenation and {{c1::redox state of cytochrome a,a3}}
Published	07/30/2024	The indication when vasopressor is indicated in patient with sepsis is when {{c1::hypotension not responsive to fluids}}
Published	07/30/2024	{{c1::D5 NSS}} is a crystalloid with the same osmolality as plasma
Published	07/30/2024	Pxs suffering from carbon monoxide usually suffer from {{c1::vasogenic}} shock
Published	07/30/2024	{{c1::IL-6::cytokine}} is elevated in response to hemorrhagic shock and a predictor of mortality
Published	07/30/2024	[VR] Hemorrhage1. Vagal Inflammatory Reflex2. Inflammation{{c1::B}}
Published	07/30/2024	Resuscitation in patients with shock is complete if {{c1::acidosis is corrected}}
Published	07/30/2024	The most common acid base abnormality expected after hypovolemic shock is {{c1::metabolic}} acidosis
Published	07/30/2024	If vasopressors are needed in patients with septic shock, the goal is to maintain the MAP at {{c1::65}} mmHg
Status	Last Update	Fields