Circulatory SHCK Unife循环性休克查.pptVIP

Circulatory SHOCK MAP = CO * TPR CO = SV * HR SV = EDV - ESV Definition Inadequate perfusion (oxygen supply) of tissues, resulting in: Organ dysfunction Cellular and organ damage And if not quickly corrected… Death Causes of Shock – a quick list: Heart Attack Anaphylaxis Loss of Circulating Blood Volume (bleeding , burns, dehydration) Venous Dilation (allergy, pain, drugs, heat stroke, infection) High or Low Body Temperature Signs of Shock Pulse: Rapid, weak, thready Tachycardia Why? Compensation for decreased MAP sensed by ___________ Baroreceptors Signs of Shock Respirations Shallow, irregular, labored May be tachypnea (increased respiratory rate.) Why? Compensation for hypoxia sensed by: Chemoreceptors Signs of Shock: MAP Blood Pressure Low, Falling Hypotension is a late finding: why? Compensatory mechanisms work at first to maintain MAP Signs of Shock Due to hypoperfusion: Decreased “mentation” - confused, sluggish, anxious Skin cold, mottled Emergency Treatment Evaluate vital signs BP, Respiration Rate, Pulse Oximeter, Temp. Control bleeding Prevent loss of body heat Causes of Shock:Classification (the real list) Low Output Circulatory Failure Hypovolemic shock (too little volume) Cardiogenic shock (pump failure) Obstructive shock Distributive shock: Venous pooling High Output Circulatory Failure Distributive Shock: Sepsis, toxic shock, anaphylaxis: Hypovolemic Shock CO reduced due to loss of intravascular VOLUME Reduced venous return Causes Most often, blood loss (hemorrhage) Dehydration Burns Fluid lost into peritoneal cavity w/ pancreatitis MAP = CO * TPR Hypovolemic Shock CO reduced due to loss of intravascular VOLUME Reduced venous return Causes Most often, blood loss (hemorrhage) Dehydration Burns Fluid lost into peritoneal cavity w/ pancreatitis MAP = CO * TPR Cardiogenic Shock Myocardial Infarction (most frequent cause) Acute Valvular Dysfunction – e.g. papillary muscle rupture post-MI Arrhythmia – e.g., heart block, ventricular tachycard