RECOGNIZING SHOCKS

Lack of blood flow that may lead to organ failure

Cardiogenic Hypovolemic Septic Anaphylactic Neurogenic
Anything that causes Hemorrhage: Response to an untreated Histamine response due Inability of the sympathetic
damage to the heart will Postpartum, upper GI infection to exposure to an nervous system to stimulate
weaking the muscle of bleed, severe blunt The end result of sepsis :( allergen nerve impulses:
the heart from properly trauma Via inhalation, Spinal cord injury (T6 or
doing its job: Other: injection, oral, or higher), TBI, drugs,
Etiology Myocardial Severe dehydration contact spinal anesthesia
infarction, due to vomiting or Ex: bee sting, food
arrhythmias, heart diarrhea, burns allergy, drug
failure, blunt reaction
trauma, myocarditis
Hypotension Hypotension Hypotension
Tachycardia Tachycardia Bradycardia
Weak thready pulse Flushed, warm, skin Warm, dry extremities,
Cool, pale skin Vasodilation (blood volume is not diminished) cold core
Oliguria (<30mL/hr) Hypothermia
Signs/Symptoms Slow capillary refill Septic: fever, BP does not respond to fluids, increased Loss of bladder control
Confusion/agitation respiratory rate Vasodilation (blood
Cardiogenic: WEAK heart; Hypovolemic: LOSS Anaphylactic: bronchoconstriction, dyspnea, wheezing, volume is not
of fluid swelling, itchy diminished)
Cardiogenic: crackles and tachypnea, chest pain
Increased CO
Cardiac Output Decreased CO Decreased CO
(may fall later on)
Systemic Vascular Increased systemic vascular resistance (due to
Decreased systemic vascular resistance (due to vasodilation)
Resistance (SVR) vasoconstriction)
Immediate EKG Trendelenburg Antibiotics FIRST within Establish airway! Keep spine immobilized
Supplemental O2 Fluids → NS or LR ONE hour of shock Trendelenburg IV fluids to increase CO
Pain control until blood can be Vasopressors Epinephrine (watch fluid overload)
Immediate matched Fluid therapy Albuterol Atropine to increase HR
reperfusion Monitor fluid Supplemental O2 Antihistamines/stero Monitor urine output
BP meds: overload (JVD, ids
Treatment Dopamine, crackles, RR) Remove the allergen
Norepinephrine, Monitor VS q15m Teach patient to
Dobutamine, Supplemental O2 carry Epi-pen
RNEXPLAINED

Pressors Monitor urine

Watch for fluid output
overload → lungs Pressors/N/D

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meds