CRITICAL CARE topic shock

2. Prep by LUQMANALI
BS ANAESTHESIA (5TH SEMESTER)

3. In this lecture we will learn:
Definition of shock
Pathophysiology
Compensatory mechanism
Stages
Types

4. Critical Hypoperfusion to tissue
OR
Physiological state characterized by
systemic reduction of O2 delivery to tissue

5. Cells switch from aerobic to anaerobic
metabolism
Lactic acid production
Cell function ceases and swells
Membrane become more permeable
Electrolytes and fluids seep in and out of cell

6. Na+/K+ Pump impaired
Mitochondria damage
Cell death

7. Increased heart rate
Vasoconstriction
Increased preload
Increased respiratory rate
Decrease renal perfusion

8. INITIAL STAGE: tissue are under perfused
COMPENSATORY STAGE: reversible stage
PROGRASSIVE STAGE: Failling
compensaory mechanism
IRREVERSIBLE STAGE: Multiple organ
disfunction

9. hypovoleumic shock
Cardiogenic shock
Anaphylactic shock
Septic shock
Neurogenic shock

10. It is caused by too little fluid volume or blood
volume
ASSESMENT:
Low blood pressure
Increased heart rate
Decreased body temprature

11. MANAGEMENT
MaximizeO2 delivery
Control blood loss
Fluid resuscitation

13. It occurs due to heart problems
ASSESMENT:
Rapid breathing
Severe shortness of breath
Loss of consciousness
Low blood pressure

14. MANAGEMENT:
vasopressors to treat low blood pressure
ionotropic agents
Aspirin

15. It is caused due to allergic reactions
ASSESMENT:
Measuring amount of certain
enzyme(tryptase) which can be elevated upto
3 hours after anaphylaxis
Wheezing
pruritis

16. MANAGEMENT:
Vasopressor to maintain organ perfusion
Positive ionotropes
I.V epinephrine
Immediate withdrawal of antigen if possible

17. It is a life threatening condition in which your
blood pressure drops to a dangerous level
after an infection
ASSESMENT:
Increased heart rate
Increased CO2
Tachypnea
Pink, warm , flushed skin

18. MANAGEMENT:
Prevention
Find and kill the source of infection
 MaximizeO2 delivery
Vasoconstrictors
ionotropic drugs

20. It is a type of shock which is occur due to
damage to nervous system
ASSESMENT:
bradycardia
Hypotension
Hypothermia
Poikilothermy

21. MANAGEMENT:
I.V fluids
Treat hypoxia
Maintain ventilatory support
Treat bradycardia with atropine

23. http://emedicine.medscap.com
http://mayoclinic.org.com
http://www,webmd.com
http://myoclevelandclinic.org.com
Textbook of anesthesia(Smith and
Aitkenhead’s)