What is the first step in managing shock in trauma patients? - ANSWER-The first
step in managing shock in trauma patients is to recognize it.
Define Shock - ANSWER-An abnormality of the circulatory system that results in
inadequate oxygen perfusion and tissue oxygenation.
List the second step in managing shock - ANSWER-Is to identify the probable
cause of shock and adjust treatment accordingly.
List the four type of shock? - ANSWER-Cardiogenic Shock
Obstructive Shock
Neurogenic Shock
Septic shock
Cardiogenic Shock caused by? - ANSWER-(Caused by blunt cardiac injury)
Suspect blunt cardiac injury when the mechanism of injury to the thorax involves
rapid deceleration.
List three causes of Cardiogenic shock - ANSWER-Cardiac Tamponade
Is most commonly encountered in patients with penetrating thoracic trauma, it
can result from blunt injury to the thorax
1. Tachycardia
2. Muffled heart sounds
3. Dilated / engorged neck veins with hypotension and insufficient response to
fluid therapy suggest cardiac tamponade
Air Embolism
Myocardial Infarction
Obstructive Shock - Consider these diagnosis with injuries above the diaphragm
- ANSWER-Tension Pneumothorax - reduces venous return resulting in
Obstructive shock
I. Acute Respiratory Distress
, II. Sub - Q emphysema
III. Absent Unilateral breath Sounds
IV. Hyper resonance to percussion
V. Tracheal Shift
Cardiac Tamponade - blood in the pericardial sac inhibits cardiac contractility
Neurogenic shock - list potential causes - ANSWER-A. Injury to the cervical or
thoracic spinal cord resulting in loss of sympathetic tone and subsequent
vasodilation
B. Isolated intracranial injuries do not cause shock, unless the brain stem is
required
C. The classic presentation of neurogenic shock is hypotension without
tachycardia or cutaneous vasoconstriction.
D. The failure of fluid resuscitation to restore organ perfusion and tissue
oxygenation suggests either continuing hemorrhage or neurogenic shock
Septic Shock - Define - ANSWER-Patients with early septic shock can have
normal circulation volume, modest tachycardia, warm skin, near normal systolic
blood pressure, and wide pulse pressure.
In which group of patients, may be the underlying reason or precipitating cause
of traumatic injury be be an unrecognized infection, commonly a urinary tract
infection. - ANSWER-In Elderly, the underlying reason or precipitating cause of
traumatic injury be be an unrecognized infection, commonly a urinary tract
infection.
____________________________ is the most common cause of shock in
trauma patients - ANSWER-Hemorrhage
Cardiac Output is comprised of what two things? - ANSWER-Cardiac Output =
Heart rate x stroke volume
Stroke Volume is classically determined by: - ANSWER-Preload, myocardial
contractility, and afterload
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