Please enable JavaScript.
Coggle requires JavaScript to display documents.
HYPOVOLEMIC SHOCK EC METABOLIC ACIDOSIS - Coggle Diagram
HYPOVOLEMIC SHOCK EC
METABOLIC ACIDOSIS
PATHOPHYSIOLOGY : LOSS OF CONCIOUSNESS
Transient loss of consciousness may be caused by trauma, intoxication, seizures, hypoglycemia, subarachnoid hemorrhage, cerebrovascular disease (involving the brainstem), or syncope.
Loss of consciousness cause by decrease of oxygen to brain and cell.
DIFFERENTIAL DIAGNOSIS : LOSS OF CONCIOUSNESS
Cardiac Arrest
Dehidration
Hypoglicemia
Hyperglycaemic hyperosmolar non-ketotic
Heart Failure
Epileptic
Hemorrhagic stroke
PRIMARY SURVEY
The common acronym for performing the primary trauma survey is ABCDE
A: Airway with cervical spine precautions /or protection.
B: Breathing and Ventilation
C: Circulation with hemorrhage control
D: Disability (assessing neurologic status)
E: Exposure and Environmental Control
This is evaluated by assessing the level of responsiveness, obvious hemorrhage, skin color, and pulse (presence, quality, and rate). The level of responsiveness can be quickly assessed by the mnemonic AVPU, as follows:
(A) Alert
(V) Respond to Verbal stimuli
(P) Respond to Painful stimuli
(U) Unresponsive to any stimuli.
SECONDARY SURVEY
A secondary survey should not be performed until:
The primary survey has been completed
Resuscitation has been initiated
All life-threatening conditions have been identified and addressed
Normalization of vital signs has started
AMPLE History
This mnemonic device can be used for obtaining a quick, focused history:
Allergy
Medications
Previous medical history or illness/pregnancy
Last meal
Events/environment related to injury
Physical Examination
This involves a complete head-to-toe examination; examine all areas including front, back, sides, under and over. This examination involves a second review of the airway and lung examination. Throughout the evaluation, standard precautions for blood or fluid-borne infections should be observed.
Vital Signs
Neurologic Examination -> GCS
ICU TRIAGE
SHOCK
Defenition
Shock is a life-threatening manifestation of circulatory failure. Circulatory shock leads to cellular and tissue hypoxia resulting in cellular death and dysfunction of vital organs. Effects of shock are reversible in the early stages, and a delay in diagnosis and/or timely initiation of treatment can lead to irreversible changes, including multiorgan failure (MOF) and death.
CLASSIFICATIONS
Hypovolemic Shock
Hypovolemic shock is characterized by decreased intravascular volume and increased systemic venous assistance (compensatory the mechanism to maintain perfusion in the early stages of shock).
Common causes of hemorrhagic hypovolemic shock include : GI bleed, vascular etiologies, spontaneus bleeding.
Common causes of non-hemorrhagic hypovolemic shock include: GI losses - the setting of vomiting, diarrhea, NG suction, or drains. Renal losses - medication-induced diuresis, endocrine disorders such as hypoaldosteronism.kin losses/insensible losses - burns, Stevens-Johnson syndrome, Toxic epidermal necrolysis, heatstroke, pyrexia.
Cardiogenic Shock
Cardiomyopathies, Arrhythmias, Mechanical - severe aortic insufficiency, severe mitral insufficiency, rupture of papillary muscles, or chordae tendinae trauma rupture of ventricular free wall aneurysm.
Distributive Shock
Characterized by peripheral vasodilatation.
Septic Shock
Systemic Inflammatory Response Syndrome
Anaphylactic Shock
Neurogenic Shock
Endocrine Shock
Obstructive Shock
Mostly due to extracardiac causes leading to a decrease in the left ventricular cardiac output
ACID-BASE DISORDER
Metabolic Alkalosis
Process that primarily raises bicarbonate:
Extracellular fluid volume loss e.g. due to vomiting or diuretics
Excessive potassium loss with subsequent hyperaldosteronism
Respiratory Acidosis
Process that primarily causes elevation in PaCO2:
Reduced effective ventilation e.g. many chronic respiratory - diseases or drugs depressing the respiratory centre
Metabolic acidosis
Process that primarily reduces bicarbonate:
Excessive H+ formation e.g. lactic acidosis, ketoacidosis
Reduced H+ excretion e.g. renal failure
Excessive HCO3- loss e.g. diarrhoea
Respiratory Alkalosis
Process that primarily causes reduction in PaCO2:
Increased ventilation e.g. in response to hypoxia or secondary to a metabolic acidosis
RESUSCITATION FLUIDS & TREATMENT
