Types of Shock
Terms
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- Neurogenic Shock
- Shock resulting from brain or spinal cord injury that causes an interuption of nerve impulses to the arteries with loss of arterial tone, dilation, and relative hypovolemia
- Signs and Symptoms of Neurogenic Shock
- Warm, red(sometimes)skin, dry skin. Pt. will have low bp (due to no catecholamine release), slow pulse in early stages.
- Treatment
- c-spine. Backboad immob. IV fluids.
- Anaphylactic Shock
- A life threatening allergic reaction. Caused by antigens
- Signs and Symptoms of Anaphylactic Shock
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Skin: Flushing, Itching, hives, swelling, cyanosis.
Respiratory System: Breathing Difficulty, Sneezing, coughing, wheezing, Stidor, Laryngeal edema, laryngospasm.
Cardiovascular system: Vasodilation, increased HR, Decreased Bp. GI: N/V, Abd. cramping, Diarrhea. Nervous System: Altered mental staus, Dizziness, headache, seizures, tearing. - Septic Shock
- Shock that develops as the result of infection carried by the bloodstream, eventually causing dysfunction of multiple organ systems
- Signs & symptoms of Septic Shock
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Progressive in the beginning. In the beginning increase in bp, in late stages bp drops.
Suspicion of septic shock is usually based on history of illness -
Multiple Organ Dysfunction Syndrome
MODS - progressive inpairment of two or more organ systems resulting from an uncontrolled inflammatory response to a severe illness or injury.
- Cause of MODS
- Sepsis and Septic shock are the most common cause. although is can be caused from any serious disease or injury that triggers a massave systemic inflammatory response.
- Systemic Inflammatory Response Syndrome
- The progression from infection to sepsis to septic shock to MODS
- Risk Factors for MODS
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>65yo, malnutrition and preexisting chronic disease such as cancer or diabetes.
Mortality Rate is 60 - 90%
MODS is major cause of death following sepsis, trauma and burn injuries. -
MODS
Primary Stage
(Primary MODS) - organ damage results directly from a specific cause such as ischemia or inadequate perfusion. Neutraphils and macrophages as well as MAST cells are "primed"
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MODS
Secondary Stage
(secondary MODS) - The next time there is an insult (additional injury or or ischemia) even if it is minor, the primed cells are activated, producing an exaggerated inflammatory response.
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Clinical Presentation of MODS
first 24 hours -
24 hours after rescucitation:
Low grade fever
tachycardia
dyspnea
altered mental status
general hypermetabolic, hyperdynamic state -
Clinical Presentation of MODS
after 1st 24 hours -
24-72hrs: Pulmonary Failure
7-10 Days: Hepatic Failure, intertinal failure begins renal failure begins. 14-21 days renal and hepatic failure, GI collapse, Immune system collapse. After 21 days: Blood system failure, Mycardial failure, Altered Mental status (encephalopathy), DEATH - Infectious Agents
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Bacteria
Viruses
Fungi
Parasites
Prions -
Bacteria
(singular bacterium) - Single Cell organism with a with a cell membrane and cytoplasm but no organized nulcleus. They bind to the cells of a host organism to otain food and support.
- Antibiotics
- Substances that destroy or inhibit microorganisms, tiny living bodies invisible to the naked eye. "destruction to Life"
- Gram Stains
- several dyes used to identify microoganisms
- Exotoxins
- Toxic(poisonous) substances secreted by bacterial cells during their growth.
- Endotoxins
- Molecules in the walls of certain Gram-negative bacteria that are released when the bacterium dies or is destroyed, causing toxic effects on the host body.
- Septicemia
- The systematic spread of toxins through the bloodstream Also called sepsis.
- Virus
- An organism much smaller than a bacterium, visible only under an electron microscope. Viruses invade and live inside the cells of the organisma they infect.
- 3 lines of defense
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Anatomic barriers
Inflammatory response
Immune response