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Shock (Four main categories of shock (Hypovolaemic shock (Severe blood or…
Shock
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Subcategories of shock
Anaphylactic shock
Results from a widespread hypersensitivity reaction to either a certain type of food, an insect bite or certain medications. It causes massive vasodilation, hypovolaemia and peripheral pooling leading to a decrease in tissue perfusion and an impairment in cellular metabolism
Neurogenic shock
Caused by increased parasympathetic stimulation and a decrease in sympathetic stimulation. There will be reduced vascular tone, massive vasodilation, decreased systemic vascular resistance, decreased cardiac output, reduced cell perfusion resulting in decreased cellular metabolism.
Septic shock
This syndrome begins with an infection that progresses to bacteraemia, sepsis, severe sepsis, septic shock and then end organ dysfunction.
Three stages of shock
- Pre-shock: Compensation for impaired tissue perfusion by homeostatic mechanisms-Low blood pressure
- Shock: Compensatory mechanisms are overwhelmed. Signs and symptoms of organ dysfunction are present-restlessness, dypnoea, oliguria, metabolic acidosis, cool clammy skin, tachycardia and diaphoresis.
- End organ dysfunction: organ damage, no urine output (acute renal failure), acidemia, coma, decreased cardiac output and death.
Definition
Shock is when the cardiovascular system fails to adequately perfuse the tissues. This then results in the widespread impairment of cellular metabolism.
Treatment options
Distributive shock: Control systemic vascular resistance, hemodynamic, source control (drain abscess), stabilize spinal chord, treat gram negative sepsis.
Hypovolaemic shock: Maximise oxygen delivery, control blood loss and fluid resuscitation.
Cardiogenic shock: IV fluids and plasma and medications to increase the hearts pumping action.
Obstructive shock: IV fluids and plasma and medications.
In all cases where shock is present, the cell either receives an inadequate amount of oxygen or cannot use oxygen.
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