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1/10/14

Shock Signs and Symptoms

Shock: Signs and Symptoms
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

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