Aakash bhardwaj

E3
 SHOCK. [Link], classify, pathophysiology. (f.] ((70-20, 10)
·

Septic shock (n-10,20]

SIRS (w -10)

·Hypovolmic shock (15-17)

&eth- shock a
is round
state which
and
in
inidespread
of effective
#t ion tissue perfusion leads first to
Revere spreesible
and
prolonged
ifthen to
- -

⑮
onjuy.

SAG
MPENSAED vompensated are

revers
-> -

Body his to
Body isit able
compensate using to compensate

compensatory mech
Anymore. ↓
↓ ↓

Ipatters
DROWSINESS
~

Unpeepaniveness
~

CRRDIA ~
OLIGURIA AURIA
v

* TACHUDNAA ~ CRT> 5S
-
BRAYCARDIA
~

"(35. HypOTENSION
~
BRADYPNAA
~

~ Nalson PP Unrecordable
~ BD
~
cold extremities
 CLASSIFICATION
- -

TYPES OF SHOR CAUST. physiological compensations

1
effect

DioGTt ·

M. Arythmia, AS, ↓ I ·
BARO Receptor
meen
purp Blood out MR, myocarditis.
·
HR and

contractibility
·↑ Systemic
vasulla
penstare
man Blood
centre?
OBSTRUCTIVE
. . .

·PRICARDIAL etfesion
um
Heat Co
Pumps well ↓
17

from
outflow
but ·

TEMPONAD
Heart
isobstructed ·TENSION ONOMOTHORAX
Massive Pul- frabolism.
·

hypovocumic
haenorhage
·

- -

what
pumps well quitos e
[romny
17

but
not enough
Blood vol Burns
pump.
to

DISTRIBUTIVE
- - *
peast well, spotic shock systems 4CO
pumps ↓ ·

butthere
is NUROGENIC
-
SHOCK Vascular HR +

PARIPHARA ANAPHYATC SHOCK. penitace contractibility

-
VABODILATEN
· No
- change in
Nemognic
-

shock.
-

↑
 of of various types of shock

Hovocomicpitisutive onpiogenic obstive

HR ④ ⑭ cwaras in ↓ ↑
newrquin)
·

how ↑ ↑
·
TVp now

Bp how how lon low.

skin Cold NAM cold cold

-

CRT
④ ① ↑ &

Pathogenesis MADP =
DBP +
/z(PP)
- .

~ -

- v N.

v.
/

⑭
 Hpovocumic stock

hypovolaemia (Haemenhage, fluid

you

↓tod
↓astolicfilling
v0
↓ Mean Asterial BP.

↓
->
in
Morgan
#ock .

SSYWAROM
classes
of reypovoluic stack
keys 1 class- clan. I
class-
-

<
-

of Blood DONATION compensated phase of

↓
rypovolanis shock. Decompensated unpandable
plan
the

Ravam
parameters
Normal
Blood loss hypovolanieB.
Brock,
Set
of sympatheticsystem
↓
↓
Ar-NA
- >

Inability to

Tchycardia
- maintain
SBP.

vasoconstricte
periphial
- -
shut stood to
vip organs
Blood 2400 -
500CC 1L 1.52 32L
= =
Loss
-

gV Massive
Elt ORA IV crytalesias
CRYSTALONDS
-
-
LiquiD5. ood
(Ns(k) coloids parfum
-
(3:1) >10 units in
↓

the

>
funits in In
= v

Magement.
Rapid Replacementof Blood, colloid,
↓ crystalia

-
spTiC sOCK

IRS-Sysviiamatory Response syndrome

d
the clinical mult
·
It is
Body Response to a

leg-intation, atamation, seen, MA, BIONS.&

Must have Atleast

of following
the

) Temp. >30.5 -
or 115C

2) HRC
obluim

3) RR >
20min
- -

4) cells/uns Olmms CBA

COMMANUt
WBCS on OR

-v.

Ssis -> SIRS +

suspectedconfirmed section
↑

LDocumentedby cestueofensmansee
to
s
shock
sepsis nofension, infectsto
Responds
- +

fluids. - v

hypoperfusion pensisting an hour after

issue
in

Crystalloid facial Administration]

eviduced
by
↓
 Ipsq
SBP
↓ in >10. from patientBAstint
by
v.h>,7.

type of sepli
shock-

-
M &
in condirgin
inc
How to
high co + t
·

LOW SVR High SVR

WARm Effunities Corn extenties

·BOUNDING PULSE ·

feeble pulse

·
FLASH (RT (<1S] Prolonged (RT(>3S]

#
N -

-
-
-..
-

- . ⑤
a
v.

V.

&

-
. . a

v
N
--

=.
=
- -
v

< -
-
MAgement
- .

EARLY RECOGNITION of Septicshock.

↓
Initial Renisitalian

one
funds (cystuleoide-
or
No

: isnotresolved

somekg -

(
resolved
Not -

fivinatory
soth

DNROPE [DOBUAAMINE 2.8ugl/min]

No response
I
Assen the patient

*
I
cown's
Warm shock nock

I ↓
 NOOR-EPINEPHRIN AppIRIN
-

↓
- - v. - -

NO
if Response
<

↓
fluid and SNOPOPE
Retractory shock.

↓
IV. HYDROCORAISONE
-
-
④
300n/day
-
x
(days
-

1900 response
v

D
EaM0 [Exha-Compareal Membrane oxygenating
-

Other meanuel

1) Acidosis, pls -> Nation

mag /kg.
2) Hypoglycenua -> pexhose

3) and generation
septicshock ->
cephalosporin
Aminoglycosides