University:
Johns Hopkins University
Course:
ME.250 | Medicine
Academic year:

2021
Views:

163

Pages:

4
Author:

Grace Scott

Datu 490. Shock is a situation when rate of artemal blend form is Inadequate to meet the fis refionas hypoxia グ Bane metabolic need. This reents in Lactic acidosίς due to anaerobic metehila endorgan damage and failure. Shock is characterized by - hypotension, tacky corrdia, oliguria 3 altered mental statue peripheon hypoperfusion and impaired oxygen delivery - General measures: prompt diagnoris and appropriali delection of the cause 2- Basic Life support: ARC 3- Mechanical ventilator: When acidosis accompanies shock IV access and fluid therapy based on vital signs. Cardiac monitoring Intmarterial access for Continuous BP monitioing and Ficathed 3 Volume Replacement: Immediate hemostasis and blond substitutes Hoz. Shock- (PRBE/Whole blood) - each wait themes by 8%. Extra volema replacement 2 crytalloids & cloating factor replacement shi- Behydration correction by crystalleries. (019Y. Norival Saltre or Ringer Lactali). Offer cause Hypovolemic Sh Cardiogenic shock with font volume overload requires (6mallen) amount of fluid challange. shock higher volume of fluid replacement Septic shock as capillary leak releases fluid into extra vous autor spolce. Unarmed fluid snay cause mypothermia induced coagulopathy. Dobutamine (relatively Bi selective) - Cardiac contouchi & afterload. but Used in Condiogenic Shock ano dont have Initial Jox 0.1-0.2 meg hypotens min 20 meg/kg/min Usnal maintanance dose meg/kg/0. 2-20 me Tachyphylaxia observed afh 98 Hre of frien (due to down regulation of receptor). Milkinone /Amsinone (PDE-Ⅲ inhibitor): Ionotropic agent i vasodilatory property. Refractory HF used in Severe • Lavosimendan! Ionodilatory action & different MOA. Sensitizes myocardium to Cart, opens kt channels. Jonodilators to be used? caution (vasodilatory propanty) (b) Corticosterids: TOC of shock secondary to Adrenalin Not benificial at all in septic shock You mcreases chance of secondary infections. They offer no immediati berifition anaphylactic shock prevent relapse of symptoms. but me Antibiotics του septre shock (d) Sodi, bicarb, med in septic shock & lactic acidosis. But clion cal trials failed to show benifit tov ft of Shock of any etiology even a severe acidos Mephentermine (Mixed action Sympathomimetic) acts on lised to Hypotension ars Spinal A & Sx. procedwas