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Stages of Shock - Metabolic Changes (Compensatory Stage - Body attempts to…
Stages of Shock - Metabolic Changes
Compensatory Stage - Body attempts to compensate to maintain homeostasis
Signs and Symptoms
Decreased spo2, increased RR, tachypnoea
Cool and clammy
Blood shunting away from lungs, ventilation perfusion mismatch
Slowing of peristalsis
Increased heart rate and contractility
Neurological changes e.g. confusion
Decreased Blood Pressure
Decreased renal blood flow, activation of the RAAS
Slowing of bowel sounds
Possible Treatment Options - Treating the cause of shock before the body is unable to compensate and experiences progressive shock
Progressive Stage - Occurs as a result when the compensatory stage can no longer maintain homeostasis
Signs and Symptoms
Increased systemic interstitial oedema
Weak peripheral pulses
Decreased coronary perfusion e.g. arrhythmia's and poor capillary refill
Bronchoconstriction, tachypnoea, crackles, increased work of breathing
Reduced cardiac output causing low BP and increased HR
Renal tubular ischaemia
Changes in mental status e.g. delirium
Liver failure resulting in jaundice
Increased bleeding
Possible Treatment Options - keeping the patient warm, position with legs raised allowing increased blood flow to the brain, fluid replacement, Oxygen therapy
Irreversible Stage - the end stage of shock with decreased perfusion and cardiac output causes anaerobic metabolism
Signs and Symptoms
extreme hypotension
Hypoxaemia
Increased capillary permeability and dilation
Unresponsive
Non-reactive and dilated pupils
Respiratory failure
Metabolic changes, accumulation of waste products
Hypothermia
Mottled and cyanotic
Treatment Options
Stop any bleeding and restart the heart
Given oxygen therapy
Keep patient warm
Treat the underlying reason for the shock