PHTLS - Shock Questions and answers

Prompt diagnosis, resuscitation, and definitive management of shock resulting from trauma are all essential in determirung patient outcome. normal metabolic functions by producing and using energy in the form of adenosine triphos phate (ATP). The most efficient method of generating this needed energy is via ? aerobic metabolism occurs without the use of oxygen Anaerobic metabolism, It is the backup power system in the body and uses stored body fat as its energy source Anaerobic metabolism The prehospital assessment of the trauma patient is directed at preventing or reversing _____ anaerobic metabolism the patient's airway is patent and that breathing and circula tion are adequate—is the major emphasis of the ? primary assessment These functions are managed in the trauma patient by the following actions: ■ Maintaining an adequate airway and ventilation, thus providing adequate oxygen to the RBCs ■ Assisting ventilation through the judicious use of supplemental oxygen ■ Maintaining adequate circulation, thus perfusing tissue cells with oxygenated blood The major complication of disruption of the normal physiology of life is known as shock. Shock is a state of change in cellular function from aerobic metabolism to anaerobic metabolism secondary to hypoperfusion of the tissue cells is a lack of tissue perfusion (oxygenation) at the cellular level that leads to anaerobic metabolism and loss of energy production needed to support life shock the most common cause of death in shock is the failure of early? resuscitation prime determinants of cellular perfusion 1. the heart 2. fluid volume 3. blood vessels 4. 4. cells of the body shock may be classified as. 1. hypovolemic shock 2. Distributive shock 3. Cardiogenic shock _______ shock is primarily hemorrhagic in the trauma patient and is related to loss of circulating blood cells with oxygen-carrying capacity and fluid volume. This is the most common cause of shock in the trauma patient. Hypovolemic shock _____ shock (or vasogenic) shock is related to abnormality in vascular tone arising from several different causes. Distrubutive shock ________ shock is related to interference with the pump action of the heart. Cardiogenic shock By far the most common cause of shock in the trauma patient is? hemorrhage Class __ hemorrhage represents a loss of up to 15% of blood volume in the adult (up to 750 milliliters [ml] 1 pt has Tachycardia Class ___ hemorrhage represents a loss of 15% to 30% of blood volume (750 to 1,500 ml). 2 Clinical findings include increased ventilatory rate, tachycardia, and a narrowed pulse pressure. The clinical clues to this phase are tachycardia, tachypnea, and normal systolic blood pressure. and the pt is has anxiety and fright. class 2 and is known as compensated shock Class ___ hemorrhage represents a loss of 30% to 40% of blood volume 1500 to 2000 ml 3 The classic findings of shock are obvious and include tachycardia (heart rate greater than 120 beats/ minute), tachypnea (ventilatory rate of 30 to 40 breaths/ minute), and severe anxiety or confusion class 3 hemorrhage represents a loss of more than 40% of blood volume (greater than 2,000 ml) class IV characterized by marked tachycardia (heart rate greater than 140 beats/minute), tachypnea (ventilatory rate greater than 35 breaths/minute), profound confusion or lethargy, and greatly decreased systolic blood pressure, typically in the range of 60 mm Hg. class IV Survival depends on immediate control of hemorrhage (surgery for internal hemorrhage) and aggressive resuscitation, including blood and plasma transfusions with minimal crystalloid CLASS IV The fluid that has been lost is whole blood containing all of its various components, including RBCs with oxygen-carrying capacity, clotting factors, and proteins to maintain oncotic pressure. Shock research has demonstrated that for lost blood, the replacement ratio with electrolyte solution should be 3 liters of replacement for each_____of blood lost LITER This high ratio ofreplacement fluid is required because only about ________to_________ of the volume of an isotonic crystalloid solution suchas normal saline or lactated Ringer's solution remains in the intravascular space 30 to 60 minutes after infusing it. one-fourth to one-third Raising the blood pressure to normal levels only serves to dilute clotting factors, disrupt any clot that has formed, and increase ? hemorrhage the goal is not to raise the blood pressure to ______ levels but to provide only enough fluid to maintain perfusion and continue to provide oxygenated RBCs to the heart, brain, and lungs. NORMAL