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Shock (States of Shock (Distributive Shock (Neurogenic Shock (Further…

- - - - Signs:
        
        Rapid and weak pulse
        
        Decreased blood pressure
        
        Decreased LOC
        
        Increased respiratory rate
        
        Cyanosis
      - Further treatment:
        
        Seal any holes in the chest
        
        Stabilize flail segments or impaled objects
        
        IV precautionary with fluid lock
      - Caused by:
        
        Severe chest injury
        
        Airway obstruction
  - - - Signs:
        
        Dyspnea
        
        Rapid and weak pulse and breaths
        
        Decreased lung compliance with decreased unilateral sounds
        
        Decreased blood pressure
        
        Trachea deviation
      - Further treatment:
        
        Chest decompression (ACP)
        
        IV precautionary with fluid lock.
    - - Signs:
        
        JVD
        
        Systolic and Diastolic Pressures becoming closer together
        
        Muffled heart sounds
        
        Small QRS complexes on ECG
      - Further treatment:
        
        Pericardiocentesis (surgery)
        
        IV precausionary with fluid lock
  - - - Further treatment:
        
        Warmed IV fluid to maintain blood pressure of 80-90mmHg
        
        Steroids
        
        Vagal blocker medications
        
        Consider vasopressors to increase blood pressure if no signs or hypovolemia are also present
      - Caused by:
        
        Cervical or thoracic spinal injury above spinal vertebra T6 causing widespread vessel dilation
      - Signs:
        
        Bradycardia or normal pulse
        
        Low blood pressure
        
        Signs of neck injury
    - - Signs:
        -Rapidly developing itching, rash, burning skin
        
        Vasodilation
        
        Generalized Edema
        
        Coma, leading to death
      - Caused by:
        
        Extreme, life threatening allergic reaction
      - Further treatment:
        
        Administer epinephrine IM
        
        Bronchodilator or antihistamine medication
        
        IV precautionary with fluid lock
    - - Signs:
        
        Warm skin
        
        Tachycardia
        
        Low blood pressure
      - Further treatment:
        
        Fluid bolus to maintain blood pressure of 80-90mmHg
        
        Medications to fight bacteria
      - Caused by:
        
        Severe bacterial infection
    - - Signs:
        
        Rapid pulse
        
        Normal or low blood pressure
      - Further treatment:
        
        Determine length of time unresponsive, suspect potential head injury.
      - The only temporary form of shock;
        Caused by:
        
        Generalized vascular dilation from anxiety, bad news, sigh of blood, severe pain or tiredness, resulting in syncopal or presynccopal episodes
- - - - Anaerobic metabolism begins, which causes lactic acid buildup.
        Acidic blood causes a right shift on the oxygen-hemoglobin association curve, further impairing myocardial oxygen delivery and cardiac function.
        Prolonged decreased Gi activity can cause stress ulcers.
        Blood, shunted away from kidneys at this point, decreased kidney perfusion, urine output, and leading towards kidney failure.
      - Anaerobic respiration gravely reduces ATP stores and the acid buildup that occurs due to that can cause cellular explosion that can release lysosomes into extracellular space to digest neighboring cells and tissues to substantiate organ failure and lead into Irreversible Shock.
      - Signs and Symptoms on the body
        
        Altered LOC either responds to verbal, pain, or unresponsive.
        
        Hypotension
        
        Labored or irregular breathing
        
        Weak or absent peripheral pulse
        
        Ashen, mottled, or cyanosed skin.
        
        Dilated pupils
        
        Scanty urine output
        
        Impending cardiac arrest
  - - - Systolic pressure will be lower than 60mmHg, preventing coronary arteries to fill as well as perfusion to the brain to diminish.
        Once blood supply to brain is low enough, the stimulus maintaining sympathetic nervous system response will no longer be able to be maintained.
        Slow blood flow through the body may cause many small clots
        The overall lack of perfusion may result in organ failure with permanent damage, or death.
        
        Amount of time an organ can go without perfusion before resulting in permanent damage:
        
        Brain/Nervous system: 4-6 minutes
        
        Skin/Muscles: Almost 2 hours
        
        Heart, Lungs, Kidneys, and Liver: 1 hour
  - - - Norepinephrine:
        Acts primarily on Alpha 1 and Alpha 2 receptors, centering on vasoconstriction and peripheral vascular resistance
      - Epinepherine:
        
        On Alpha 1: Promotes vasoconstriction, increases peripheral vascular ressistance, and increases afterload.
        
        On Alpha 2: ensures a regulated release on Alpha 1 receptors.
        
        On Beta receptors: Acts primarily on heart and lungs by increasing heart rate, contractility, conductivity and automaticity in tandem with bronchodilation.
      - Signs and symptoms on the body
        
        Agitation, anxiety & restlessness
        
        Weak, rapid pulse
        
        Cool, clammy skin
        
        Pale skin, with cyanosed lips
        
        Shortness of breath
        
        Nausea and vomitting
        
        Thirst
        
        Normal Blood pressure

Explanation paragraph/points

To explain my map is to read through it. Start from center and go right into stages of shock. The information can be read from top to bottom, one line at a time. Following this, read along the states of shock to the left. These can be read in any order. Regarding treatment, the yellow section gives the generalized priorities to follow for any shock patient, while each state of shock includes the causes, signs and symptoms, and treatment that may be specific to that state of shock.

To me, this mind map represents the spectrum of shock and shows the differences between different states and stages of the process. As I am not a visual learner, this mind map includes as many words and descriptions organized in a flowing order to make sense to me.

I included what I did in my mind map because I am detail-oriented and the details included were the most relevant for me to understand the physiology of each state and stage.

I did not leave anything out that I found relevant. Using Nancy as a resource, however, I learned about respiratory insufficient shock and psychogenic shock that were not covered in class and included them in order to be clear that shock symptoms can appear from the sight of blood (psychogenic) or from respiratory failure separate from a pump, vessel, or fluid failure.

The research I did for this assignment was helpful to me. The assignment itself, since I am not a visual learner, did not cement any of this knowledge and based on my study habits, if I were to study shock for a test, I would sooner look back on the notes than the finished project.