4 Distributive and Septic Shock Free Online FlashCards

What causes distributive shock?

Widespread vasodilation and altered blood flow impair tissue perfusion, even when total blood volume is not initially depleted.

What are three causes of distributive shock?

Sepsis, anaphylaxis, and neurogenic injury are causes of distributive shock.

How can skin appearance change as septic shock progresses?

Early septic shock may cause warm, flushed skin and bounding pulses; later, vasoconstriction may make skin cool and clammy.

Does normal blood pressure rule out early shock?

No. Early shock can impair perfusion before marked hypotension develops, so a normal blood pressure does not rule it out.

What findings can signal impaired perfusion in suspected sepsis?

New confusion or drowsiness, reduced urine output, delayed capillary refill, and elevated lactate can indicate impaired perfusion or organ dysfunction.

What does lactate alone not establish in suspected sepsis?

Elevated lactate can signal impaired perfusion, but lactate alone does not identify the infection source.

What should an initial adult assessment for suspected septic shock include?

Promptly assess airway, breathing, circulation, vital signs, oxygenation, perfusion, and likely infection source; escalate care and begin sepsis treatment.

What should guide ongoing fluid treatment in septic shock?

Reassess perfusion and fluid responsiveness frequently; monitor vital signs and urine output, and follow lactate trends when appropriate.

Which vasopressor is first line for persistent hypotension in adult septic shock?

Norepinephrine is the recommended first-line vasopressor for adults with septic shock when hypotension persists after initial fluid resuscitation.

What is the priority intervention for suspected anaphylaxis?

Give intramuscular epinephrine promptly and activate the emergency response. Antihistamines are not a substitute for epinephrine.

When should clinicians assess whether septic shock requires source control?

Rapidly evaluate whether the infection source requires source control; do not wait for shock to resolve before investigating.

What initial IV crystalloid volume does the guideline suggest for adult septic shock?

For adults with sepsis-induced hypoperfusion or septic shock, the guideline suggests at least $30\,\text{mL}\,\text{kg}^{-1}$ of IV crystalloid within the first 3 hours, individualized to the patient and followed by frequent reassessment.