Shock II (care for shock pt)

  1. What is emergency care for the shock pt?
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    • keep pt still
    • prevent heat loss
    • NPO
    • Monitor and record vitals.
  2. What is Rothberg's position and why would you use it?
    • HOB 45 degrees, feet/legs elevated 15. 
    • Use for shock pt who has is having difficulty breathing.
  3. What is initial management of hypovolemic shock?
    • Find and control hemorrhage. Could also be internal.
    • Restore volume by infusing crystalloids (LC, 3-5% NaCl) and blood/blood products. Watch for e-lyte imbalances especially in dehydration hypovolemia. 
    • Airway and admin O2.
  4. What is initial management of cardiogenic shock?
    • Restore or replace heart function.
    • Invasive monitoring (swangans). 
    • Agressive airway maintenance 
    • Fluid replacement
    • Pressors
    • --Dobutamine for tachy + ^ SVR
    • --Dopamine for tachy + v SVR
    • --*both will ^ contractility
    • Other drugs
    • --morphine for anti-anxiety
    • --cautious use of diuretics for CHF
    • --Vasodilators for afterload reduction
    • --Short acting BBlockers (esmolol) for refractory tachy.
    • Consider thrombolytics, angioplasty, and aortic balloon counterpulsation if appropriate.
  5. What is initial management of septic shock?
    • ABX
    • Fluid resusitation
    • Vasopressors
    • --Dopamine
    • --Levophed
  6. What is MODS?
    • Multiple Organ Dysfunction Syndrome
    • leading cause of death in trauma or sepsis
    • High mortality rate (40-90%)
    • In shock, is caused secondary to poor organ perfusion and inflammation
  7. Interventions for MODS?
    • Balance O2
    • Nutritional support
    • Control source of inflammation/nfxn
  8. What causes ARDS in shock pts?
    Hypoxic destruction of alveolar/capillary interface.
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Shock II (care for shock pt)
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