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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
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
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
>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"
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.
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
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
Anatomic barriers
Inflammatory response
Immune response

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