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Shock (CARDIOGENIC SHOCK (Symtoms: (Similar to one with acute…

- - - - Baroreceptors in the carotid and aortic bodies activate the SNS, stimulating vasoconstriction and release of potent vasoconstrictors such as adrenaline and noradrenaline.
      - Blood flow is then directed to most essential organs such as brain and heart, while blood flow to non-essential organs such as GI tract, kidneys, lungs and skin is shunted and diverted.
        
        Decreased blood flow to GI tract results in impaired mobility and slowing of peristalsis - increased risk of paralytic ileus
        
        Decreased blood flow to skin results in PT feeling cool and clammy, unless septic shock is beginning
        
        Decreased blood flow to kidneys stimulates RAS, renin stimulates angiotensinogen to produce angiotensin I which is converted to angiotensin II - a potent vasoconstrictor
        
        Causes both arterial and venous return to the heart to increase = increase in BP
  - - - Affects PT's mental status
    - - CO decreases, resulting in decrease in BP and coronary artery, cerebral and peripheral perfusion, continued decreased cellular perfusion resulting in altered capillary permeability affecting organs such as liver, spleen, GI tract and lungs.
      - Can result in myocardial dysfunction, arrhymias, myocardial ischaemia and possible MI.
    - - Jaundice can result due to accumulation of bilirubin
  - - - Increased lactic acid contributes to increase in capillary permeability and dilation. Allows fluid and plasma proteins to leave vascular space and move into interstitial space.
        
        Worsening hypotension, tachycardia, and decreases coronary blood flow leading to worsening in myocardial depression enhancing decline in CO
- - - - Occurs when fluid is lost via haemorrhage, GI loss, diabetes, fistula drainage or diuresis
    - - When fluid moves out of vascular space into extravascular space. This shift is called third spacing
      - Possible causes: fluid shifts, internal bleeding, massive vasodilation such as sepsis
- - - - Acute, life-threatening hypersensitivity reaction to substance such as drug, chemical, food, venom.
      - Reaction quickly causes massive vasodilation and increase in capillary permeability
      - dizziness, chest pain, incontinence, swelling of lips and tongue, wheezing and stridor
    - - Can occur within 30 minutes of a spinal cord injury at T5 or above can last 6 weeks
      - Injury results in massive vasodilation leading to pooling of blood in blood vessels, tissue hyper perfusion and impaired cellular metabolism
      - Hypotension, bradycardia and, inability to regulate body temperature due to vasodilation
    - - Systemic inflammatory response to suspected infection
      - Most commonly caused by gram-negative and gram-positive bacteria
      - A lot of clinical presentations such as
        
        Vasodilation, hypovolaemia, hypotension
        
        Poor oxygen delivery and tissue hypoxia
        
        Maldistribution of blood flow and myocardial depression