6 Shock Management: Integrated Practice Free Online FlashCards

What is shock?

Shock is acute circulatory failure that prevents tissues from receiving enough oxygen.

Why should clinicians not wait for hypotension to suspect shock?

Altered mentation, weak pulses, cool or mottled skin, delayed capillary refill, low urine output, and tachypnea can signal shock. Hypotension may appear late.

What four mechanisms organize the main types of shock?

The key mechanisms are too little circulating volume, pump failure, abnormal vessel dilation or distribution, and mechanical blockage: hypovolemic, cardiogenic, distributive, and obstructive shock.

What does a distended abdomen suggest in a hypotensive trauma patient without visible bleeding?

A distended abdomen after trauma raises concern for internal hemorrhage and hypovolemic shock, even without visible bleeding. Prioritize hemorrhage control and prepare blood products and definitive bleeding control.

How should suspected cardiogenic shock with pulmonary crackles be managed?

Acute myocardial infarction with hypotension and bilateral crackles suggests cardiogenic shock. Support oxygenation and urgently activate cardiology or revascularization care; avoid reflexive large-volume fluid administration.

What are key early priorities in suspected septic shock?

Promptly give appropriate antimicrobials, assess for source control, and administer crystalloid with frequent reassessment. Obtain cultures when feasible without delaying treatment.

What is the initial lifesaving treatment for anaphylactic shock?

Hives, lip swelling, wheezing, and hypotension after a medication suggest anaphylactic shock. Give intramuscular epinephrine promptly; antihistamines do not replace it as the initial lifesaving treatment.

What is the priority when tension pneumothorax is strongly suspected in an unstable patient?

Suspected tension pneumothorax in an unstable patient requires urgent chest decompression, followed by chest tube placement. Do not delay decompression for imaging.

Which findings suggest cardiac tamponade causing obstructive shock?

Hypotension, tachycardia, distended neck veins, distant heart sounds, and pericardial fluid impairing cardiac filling suggest tamponade. Arrange immediate definitive decompression and trauma or surgical management.

What pattern suggests high-risk pulmonary embolism causing obstructive shock?

Sudden dyspnea, chest discomfort, hypotension, hypoxemia, relatively clear lungs, and right-ventricular strain suggest high-risk pulmonary embolism. Support oxygenation and circulation and obtain urgent specialist assessment for definitive treatment.

What actions should proceed in parallel during undifferentiated shock?

Summon emergency help, assess airway and breathing, provide oxygen when indicated, establish vascular access, monitor ECG and oxygen saturation, and rapidly search for reversible causes. Do not let tests delay lifesaving treatment of an obvious emergency.

How should clinicians judge response to shock treatment?

Follow trends in mental status, pulse quality, skin perfusion, MAP, urine output, oxygenation, and lactate when available; also watch for fluid overload. If perfusion does not improve, reconsider the diagnosis, mixed shock, and ongoing losses.