Shock: Signs and Symptoms
|
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Type
|
Anaphylactic
(allergic reaction)
|
Cardiogenic
(pump failure)
|
Hypovolemic
(low volume)
|
Neurogenic
(spinal shock)
|
Septic
(septicemia)
|
Pathophys
|
Vasodilatation,
fluid shifts,
laryngeal and
peripheral
edema,
bronchospasms
|
↓ CO d/t lack of
contractile
force, ↓ BP,
↓ tissue
perfusion
|
Decrease in intravascular
volume
causing decreased
tissue
perfusion
|
Profound vasodilatation
causing
↓ BP and
decreased
tissue perfusion
|
Circulatory failure d/t
systemic inflammatory
response,
capillary leak
syndrome, and
↓ tissue perfusion
|
Etiology
|
Acute, lifethreatening
allergic reaction
to a specific
antigen
|
AMI, acute PE,
tamponade,
right or left
vent failure
|
Low circulating
volume d/t burns,
hemorrhage, 3rd
spacing, trauma,
dehydration
|
Traumatic spinal
cord injury,
anesthesia
|
Endotoxin release
usually from gramnegative
organism
|
Clinical
Findings
|
Respiratory distress,
hypotension,
edema,
rash, cool, pale
skin, possible
seizure activity
|
↑ HR, weak
pulses, ↑ cap
refill, cyanosis,
dysrhythmias,
ALOC, cool,
clammy skin
|
↓ BP, ↑ HR, weak
pulses, ↑ cap
refill, cyanosis,
dysrhythmias,
ALOC, cool,
clammy skin
|
↓ BP, ↓ HR,
bounding
pulse, pale,
warm, and dry
skin
|
Flushed, warm skin,
vasodilatation
(early), ↑ temp,
↓ UO (late), vasoconstriction
(late)
|
Interventions
|
ABCs
Oxygen
Antihistamine
Epinephrine
IV fluids
Corticosteroids
|
ABCs
Oxygen
IV fluids
Vasopressors
|
ABCs
Oxygen
Control bleeding
Immobilize c-spine
if trauma
IV fluids
Colloids
|
ABCs
Immobilize cspine
if trauma
Oxygen
IV fluids
Lie flat
Vasopressors
|
ABCs
Oxygen
IV fluids
Blood Cx, UA
Sputum C&S
Antibiotic therapy
Vasopressors
|
1/10/14
Shock Signs and Symptoms
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