SHOCK

cardiovascular system fails to supply oxygen according to demand due to circulatory compnents leading to hypoperfusion and release of inflammatory mediators

A change in VS, especially a MAP<60 mm Hg accomapnied by evidence of hypoperfusion

decreased urine output, rise in liver enxymes, BUN and Cr, tachypnea, hypoxemia, blood in bodily excretions, hypoglycemia

Compensatory, Progressive, Refractory

increase in heart rate and contractility, vasocontriction
ADH leads to water and sodium retention
gluticosteroids by adrenal cortex cause High BGL

previous stage doesnt meet oxygen demands so...
cells become anaerobic which has a by product of lactic acid
vasodilation, tissue edema

MODS (irreversible), death

cardiogenic, hypovolemic, obstructive, distributive

hypovolemic

hemorrhage, dehydration, burns

-admin isotonic fluids FIRST such as NS
-admin crystalloid solution, blood, colloid solution
-follow 300 mL of NS for every 100 mL of blood lost

MI, arrhythmias, valve or septal issue, cardiac surgery

Inotropic agents increase contractility
Vasopressors increase BP

dobutamine

nitroprusside

intra-aortic balloon pump and ventricular assist devices

contractility decreases so blood remains in chambers, this lowers CO and ejection fraction. BP drops so reflex vasoconstriction kicks in, which decreases perfusion in pulmonary capillaries and lowers ox perfusion

cardiac tamponade, tension pneumo, PE

pericardiocentesis, needle thoracentesis, TpA

decreased ventricular filling followed by low CO, low BP

neurogenic, anaphylactic, septic

EPINEPHRINE
REMOVE ANTIGEN

0.2-0.5 mg IM in thigh q5-15 min anterolateral thigh
IR: bronchodilation, vasoconstriction, contractility

imbalanced sympathetic/parsympathetic stimulation leads to vasodilation which decreases CO

C3 C4 C5

traction/surgery to stabilize injury, treat hypoglycemia

microorganism initiate inflammatory response which causes massive vasodilation. lactic acid builds up

antibiotics, NOREPINEPHRINE

2 blood cultures, urine, sputum, and wound cultures to start antibx within ONE HOUR

is the progressive dysfunction of two or more organ systems as a result of an uncontrolled inflammatory response to severe illness or injury

sepsis and septic shock

sedation, paralytics, antipyretics, analgesics, cooling measures

ABGs, lactic acid, hgb, hct, BUN, Cr, liver enzymes, electrolytes