Shock (Cardiogenic (Systolic dysfunction is the hearts inability to pump…
Is a result of reduced cardiac output due to either systolic or diastolic dysfunction of the hearts pumping action
60% Mortality rate
Decreased stroke volume is caused due to decreased filling of the heart
Systolic dysfunction is the hearts inability to pump blood forward. Affecting the left ventricle.
Myocardial infarction, cardiomyopathy, blunt cardiac injury, severe systemic or pulmonary hypertension, myocardial depression from metabolic problems.
Clinical presentation - tachycardia, hypotension, narrowed pulse pressure during systole and increased volume during diastole. Increase systemic vascular resistance, increased workload of the heart, increase myocardial oxygen consumption. Tachypnoeic, crackles on auscultation due to pulmonary congestion.
Most common cause is myocardial infarction
Diastolic dysfunction = inability of the heart to fill
Cardiac tamponade, ventricular hypertrophy, cardiomyopathy
Results due to fluid loss through haemorrhage, gastrointestinal loss, fistula drainage, diabetes insipidus, or diuresis.
Fluid moves out of the vascular space into the extravascular space due to increased capillary permeability. Often seen in burns.
Hypovolaemic shock occurs due to a decrease or loss of intravascular fluid causing an inadequate volume to fill the vascular space. The volume loss is either absolute or relative.
Septic shock is caused due to uncontrolled septicaemia caused by impaired cellular metabolism. When an infection is present it triggers the inflammation response in which affects the normal cellular and tissue functions.
Signs & Symptoms; Irregular temperature, pallor, oliguria, tachycardia, hypotension and fatigue.
Septic shock is treated with vasopressor administration, IV antibiotics, IV fluids and corticosteroids
Caused by abnormal distribution of blood flow in the capillaries resulting in inadequate blood supply in the organs and tissues.
Signs and Symptoms consist of an altered mental state, hyperventilation, tachypnea, decreased blood pressure, tachycardia, weak pulse, pallor, cyanosis and a decrease in capillary refill.
Treatments for distributive shock consists of IV fluids and oxygen supplements. The patient would also require an ECG and vitals monitored.
Anaphylactic shock is cause by an allergic reaction. This reaction is triggered by an antigen and initiates the inflammation response causing fluid to flow into the interstitial. When this occurs there is an impaired cellular metabolism and hypovolaemia.
Signs and Symptoms of anaphylactic shock consist of restricted breathing and swallowing, visual rashes and hives, swelling of the face, nausea, pain often in the abdomen, vomiting and tachycardia.
Treatment of Anaphylactic shock consists of immediate administration of adrenaline as this decreases the severity of the reaction. Administer antihistamine. In serious cases when the patient becomes unconscious CPR is to performed.
Neurogenic shock is caused by severe vasodilation, damage to the CNS and spinal cord.
Causes hypovolaemia and impaired cellular metabolism.
Neurogenic shock signs and symptoms consists of; chest and back pain, bradycardia, cyanosis, hypothermia, decreased mobility and numbness in the peripheries.
Treatments; administer IV fluids to maintain adequate blood pressure.
Stages of Shock
Compensatory - Progressive - Irreversible -
Shock is characterised by the decreased tissue perfusion and impaired cellular metabolism.