ATCN Chapter 3 Shock (2024) – Questions/Answers
What is the first step in managing shock in trauma patients? ✔️Ans -The
first step in managing shock in trauma patients is to recognize it.
Define Shock ✔️Ans -An abnormality of the circulatory system that results
in inadequate oxygen perfusion and tissue oxygenation.
List the second step in managing shock ✔️Ans -Is to identify the probable
cause of shock and adjust treatment accordingly.
List the four type of shock? ✔️Ans -Cardiogenic Shock
Obstructive Shock
Neurogenic Shock
Septic shock
Cardiogenic Shock caused by? ✔️Ans -(Caused by blunt cardiac injury)
Suspect blunt cardiac injury when the mechanism of injury to the thorax
involves rapid deceleration.
List three causes of Cardiogenic shock ✔️Ans -Cardiac Tamponade
Is most commonly encountered in patients with penetrating thoracic trauma,
it can result from blunt injury to the thorax
1. Tachycardia
2. Muffled heart sounds
3. Dilated / engorged neck veins with hypotension and insufficient response
to fluid therapy suggest cardiac tamponade
Air Embolism
Myocardial Infarction
Obstructive Shock - Consider these diagnosis with injuries above the
diaphragm ✔️Ans -Tension Pneumothorax - reduces venous return
resulting in Obstructive shock
I. Acute Respiratory Distress
II. Sub - Q emphysema
III. Absent Unilateral breath Sounds
IV. Hyper resonance to percussion
V. Tracheal Shift
, Cardiac Tamponade - blood in the pericardial sac inhibits cardiac contractility
Neurogenic shock - list potential causes ✔️Ans -A. Injury to the cervical or
thoracic spinal cord resulting in loss of sympathetic tone and subsequent
vasodilation
B. Isolated intracranial injuries do not cause shock, unless the brain stem is
required
C. The classic presentation of neurogenic shock is hypotension without
tachycardia or cutaneous vasoconstriction.
D. The failure of fluid resuscitation to restore organ perfusion and tissue
oxygenation suggests either continuing hemorrhage or neurogenic shock
Septic Shock - Define ✔️Ans -Patients with early septic shock can have
normal circulation volume, modest tachycardia, warm skin, near normal
systolic blood pressure, and wide pulse pressure.
In which group of patients, may be the underlying reason or precipitating
cause of traumatic injury be be an unrecognized infection, commonly a
urinary tract infection. ✔️Ans -In Elderly, the underlying reason or
precipitating cause of traumatic injury be be an unrecognized infection,
commonly a urinary tract infection.
____________________________ is the most common cause of shock in trauma
patients ✔️Ans -Hemorrhage
Cardiac Output is comprised of what two things? ✔️Ans -Cardiac Output =
Heart rate x stroke volume
Stroke Volume is classically determined by: ✔️Ans -Preload, myocardial
contractility, and afterload
Define Preload - ✔️Ans -Is the filling of the ventricles, volume of venous
blood returning to the left and right side fo the heart, is determined by venous
capacitance, volume status, and the difference between mean venous systemic
pressure and right arterial pressure.
Nearly __________________% of the bodies total blood volume is estimated to be in
the venous circuit ✔️Ans -70% of the blood volume
What is the first step in managing shock in trauma patients? ✔️Ans -The
first step in managing shock in trauma patients is to recognize it.
Define Shock ✔️Ans -An abnormality of the circulatory system that results
in inadequate oxygen perfusion and tissue oxygenation.
List the second step in managing shock ✔️Ans -Is to identify the probable
cause of shock and adjust treatment accordingly.
List the four type of shock? ✔️Ans -Cardiogenic Shock
Obstructive Shock
Neurogenic Shock
Septic shock
Cardiogenic Shock caused by? ✔️Ans -(Caused by blunt cardiac injury)
Suspect blunt cardiac injury when the mechanism of injury to the thorax
involves rapid deceleration.
List three causes of Cardiogenic shock ✔️Ans -Cardiac Tamponade
Is most commonly encountered in patients with penetrating thoracic trauma,
it can result from blunt injury to the thorax
1. Tachycardia
2. Muffled heart sounds
3. Dilated / engorged neck veins with hypotension and insufficient response
to fluid therapy suggest cardiac tamponade
Air Embolism
Myocardial Infarction
Obstructive Shock - Consider these diagnosis with injuries above the
diaphragm ✔️Ans -Tension Pneumothorax - reduces venous return
resulting in Obstructive shock
I. Acute Respiratory Distress
II. Sub - Q emphysema
III. Absent Unilateral breath Sounds
IV. Hyper resonance to percussion
V. Tracheal Shift
, Cardiac Tamponade - blood in the pericardial sac inhibits cardiac contractility
Neurogenic shock - list potential causes ✔️Ans -A. Injury to the cervical or
thoracic spinal cord resulting in loss of sympathetic tone and subsequent
vasodilation
B. Isolated intracranial injuries do not cause shock, unless the brain stem is
required
C. The classic presentation of neurogenic shock is hypotension without
tachycardia or cutaneous vasoconstriction.
D. The failure of fluid resuscitation to restore organ perfusion and tissue
oxygenation suggests either continuing hemorrhage or neurogenic shock
Septic Shock - Define ✔️Ans -Patients with early septic shock can have
normal circulation volume, modest tachycardia, warm skin, near normal
systolic blood pressure, and wide pulse pressure.
In which group of patients, may be the underlying reason or precipitating
cause of traumatic injury be be an unrecognized infection, commonly a
urinary tract infection. ✔️Ans -In Elderly, the underlying reason or
precipitating cause of traumatic injury be be an unrecognized infection,
commonly a urinary tract infection.
____________________________ is the most common cause of shock in trauma
patients ✔️Ans -Hemorrhage
Cardiac Output is comprised of what two things? ✔️Ans -Cardiac Output =
Heart rate x stroke volume
Stroke Volume is classically determined by: ✔️Ans -Preload, myocardial
contractility, and afterload
Define Preload - ✔️Ans -Is the filling of the ventricles, volume of venous
blood returning to the left and right side fo the heart, is determined by venous
capacitance, volume status, and the difference between mean venous systemic
pressure and right arterial pressure.
Nearly __________________% of the bodies total blood volume is estimated to be in
the venous circuit ✔️Ans -70% of the blood volume
