Slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. Hypoxic:there isn’t enough oxygen, duuh. Shock - Classification and Pathophysiological Principles of Therapeutics. No public clipboards found for this slide. The management of patients with shock is extremely challenging because of the myriad of possible clinical presentations in cardiogenic shock, septic shock and hypovolemic shock and the limitations of contemporary therapeutic options. Anaphylaxis is a serious allergic reaction that is rapid in onset and may cause death. The clinical classification of shock into cardiogenic, obstructive, hypovolaemic or distributive shock can help the clinician to understand the underlying cause of the shock. You can change your ad preferences anytime. Adequate or elevated filling pressures. Lecture 8 Maryam almulhem, ms, rrt. These symptoms typically come on over minutes to hours. Hyperventilation ( Minimal effect in humans) Vasodilatation of the vessels Flush ( Increase blood flow to the skin) BP Real shock 4 Classification of Shock. Shock is the state of insufficient blood flow to the tissues of the body as a result of problems with the circulatory system. Septic shock is the only type of shock where the ‘rules’ can change. in children can be considered as one of the most common presentations that are life-threatening to the emergency pediatric department. Cardiogenic shock ( heart does not pump enough blood) is caused by: uyocardial infarction Y weak cardiac As a muscle contraction result of Ischemia Arrhythmia ( such as ventricular fibrillation, which will stop the heart pump and that will decrease BP m Note: pupraventricular (Atria) fibrillation will not cause shock because 75% of the blood transfer from the atrium to the ventricles by passive transport. Arrhythmic shock. Arrhythmia. Low preload shock – tachycardia, vasoconstriction, mildly decreased BP Low afterload (distributive) shock – peripheral vasodilation, hyperdynamic state Shock Medline ® Abstract for Reference 1 of 'Definition, classification, etiology, and pathophysiology of shock in adults' PATHOPHYSIOLOGY OF SHOCK  Cellular  Micro vascular  Systemic -Cardiovascular -Respiratory -Renal -Endocrine 4. 7.3. It typically causes more than one of the following: an itchy rash, throat or tongue swelling, shortness of breath, vomiting, lightheadedness, low blood pressure. SHOCKSHOCK SYNDROMESYNDROME • Shock is a condition in which the cardiovascular system fails to perfuse tissues adequately • An impaired cardiac pump, circulatory system, and/or volume can lead to compromised blood flow to tissues • Inadequate tissue perfusion can result in: – generalized cellular hypoxia (starvation) – widespread impairment of cellular metabolism The classification of hemorrhage into 4 classes based on clinical signs is a useful tool for estimating the percentage of acute blood loss. Cardiogenic shock. However, it is important to note that considerable overlap between these different types of shock can exist in practice. tamponade or valve failure) See our Privacy Policy and User Agreement for details. DEFINITION OF SHOCK  Shock is a systemic state of low tissue perfusion, which is inadequate for normal cellular... 3. LV failure (“cardiogenic” shock) Gain access quickly- if necessary use an intraoseous line. The objective is to restore efficient cardiac output. Recognition and Classification Initial Management of Shock Final Thoughts Recognize compensated shock quickly- have a high index of suspicion, remember tachycardia is an early sign. Keywords: Shock, peripheral circulatory failure, cardiogenic shock ,anaphylactic shock. 8 Key Words: Shock, hypovolaemic shock, cardiogenic shock, intra-aortic balloon pump, acute myocardial infarction Shock, or cardiovascular collapse, is a clinical condition diagnosed in the presence of: • hypotension (i.e. SHOCK: Classification, Pathophysiology and Approach to Management Darin Stettler D.O. The difference between stages B and C is the presence of hypoperfusion which is present in stages C and higher. Fluid, fluid, fluid - Administer adequate amounts of fluid rapidly. Reduced cardiac index(<1.8 L/min per m2) <2.0-2.2 L/min per m2 with support. cardiogenic shock Histotoxic:the cells receive plenty of oxygen, but are unable to utilize it, eg. See our Privacy Policy and User Agreement for details. Clipping is a handy way to collect important slides you want to go back to later. Hemorrhagic deaths typically occur very early, usually within the first 6 h of admission, and early hypo perfusion or shock has been demonstrated to promote coagulopathy (1). Classification of shock 1. CLASSIFICATION 1 • Primary (INITIAL SHOCK) • Secondary (TRUE SHOCK) • Anaphylactic (Type I immunologic reaction) • True shock- circulatory imbalance between oxygen supply and oxygen requirements at cellular level; hence name CIRCULATORY SHOCK. FPnotebook.com is a rapid access, point-of-care medical reference for primary care and emergency clinicians. Shock is Variable IMPRESS Trial •SBP < 90 for 30 minutes •Pressors to SBP > 90 •All pts intubated •90% cardiac arrest •20 minutes to ROSC •70-80% induced hypothermia •Signs of Hypoperfusion •(Lactate > 7-8, pH 7.1-7.2) IABP SHOCK II Trial •SBP < 90 for 30 minutes •Pressors to SBP > 90 •Pulmonary Congestion •Signs of Hypoperfusion In the event of worsening signs with vascular collapse, use a strong cardiotonic: hypovolemic, cardiogenic, distributive, and obstructive) See our User Agreement and Privacy Policy. STN E-Library 2012 24 4_Hemorrhagic Shock The term mechanical shock includes those elements like tools or fingers that are in cont act with The mucus membrane colour may be bright red and animal may be hyperthermic. Hemorrhage (external, GI bleed, retroperitoneal bleed, intra-peritoneal bleed, hemothorax, post-partum). CARDIOGENIC SHOCK - Cardiogenic shock is characterized by both systolic and diastolic dysfunction Decreased coronary perfusion pressure and increased myocardial oxygen demand play a ... | PowerPoint PPT presentation | free to view Looks like you’ve clipped this slide to already. There are four major types of shock, each of which can be caused by a number of different events. Obstructive shock occurs when blood can’t get where it needs to go. The treatment of cardiogenic shock depends on its mechanism. We use your LinkedIn profile and activity data to personalize ads and to show you more relevant ads. Now customize the name of a clipboard to store your clips. Clipping is a handy way to collect important slides you want to go back to later. If you continue browsing the site, you agree to the use of cookies on this website. See our User Agreement and Privacy Policy. As an example, in a trial of 1600 patients with undifferentiated shock, septic shock occurred in 62 percent, cardiogenic shock in 16 percent, hypovolemic shock in 16 percent, other types of distributive shock in 4 percent (eg, neurogenic shock, anaphylaxis), and obstructive shock in 2 percent . Predicting blood loss in percent is really important to determine treatments of patients with traumatic injury, which can cause to death by hypovolemic hemorrhagic shock. If you continue browsing the site, you agree to the use of cookies on this website. Hypovolemic (e.g., vomiting, diarrhea, over-diuresis, post-ATN or post-obstructive polyuria). This classification system is also useful in emphasizing the early signs and pathophysiology of shock. Slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. – Acute left heart failure with pulmonary oedema. show The main pathophysiological mechanisms involved in acute traumatic coagulopathy and transfusion strategy. Looks like you’ve clipped this slide to already. Mechanical failure (eg. a systolic blood pressure less than 90 mmHg or a mean arterial pressure [MAP] less Stage A is “at risk” for cardiogenic shock, stage B is “beginning” shock, stage C is “classic” cardiogenic shock, stage D is “deteriorating”, and E is “extremis”. Shock is classified according to the causes to three classes: Hypovolemic shock Distributive shock Cardiogenic shock Causes of Shock. Slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. This may be followed by confusion, unconsciousness, or cardiac arrest, as complications worsen. If you continue browsing the site, you agree to the use of cookies on this website. If you continue browsing the site, you agree to the use of cookies on this website. in cyanide poisoning The volemic shock (inadequat e preload) and cardi o genic shock (impaired cardiac contractility) are characterized by low left ventricular stroke vol ume, though unlike hyp o volemic Shock. The glucose in the blood may also drop, rather than increasing. View Notes - lecture 8.ppt from MATH Algebra at High School Of Telecommunications. Cardiomyopathy. You can change your ad preferences anytime. We use your LinkedIn profile and activity data to personalize ads and to show you more relevant ads. 90 mmHg or a mean arterial pressure [ MAP ] less cardiogenic shock on... Access quickly- if necessary use an intraoseous line get where it needs to.. 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