Shock (an introduction)

definition, classification & about hypovolemic shock

1. SHOCK
By:
Ismah-Nuramalina-Kauthar-Khiddir-Norashikin-Bashirah-Fazwan

2. Shock is "a momentary pause in the act of death."--
John Collins Warren
Mid 1800s
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Source: Oregon Health & Science University ; http://ohsu-hca.blogspot.com/

3. A state in which the oxygen and metabolic demands
of the body are not met by the cardiac output
What is shock?
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Source: An Introduction to Clinical Emergency Medicine. Swaminatha V.M and Gus M.G. Cambridge University Press; 2005.

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SHOCK
hypovolemic
cardiogenic
obstructive
distributive
Classification
Source: An Introduction to Clinical Emergency Medicine. Swaminatha V.M and Gus M.G. Cambridge University Press; 2005.

5. Hypovolemic Shock
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6. The loss of intravascular volume
Definition
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Source: An Introduction to Clinical Emergency Medicine. Swaminatha V.M and Gus M.G. Cambridge University Press; 2005.

7. Traumatic

Vascular
-e.g. ruptured aneurysm, arterial dissection

Gastrointestinal
-e.g. bleeding peptic ulcer

Pregnancy related
-e.g. ruptured ectopic pregnancy
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Causes
Source: http://emedicine.medscape.com/article/760145-clinical#a0218

8. Class I Class II Class III Class IV
Blood loss
(%, ml)
<15, 750 15-30,
800-1500
30-40,
1500-2000
>40,
>2000
Blood pressure
(Systolic,
Diastolic)
Unchanged,
unchanged
Normal, raised Reduced, reduced Very low, very low
or unrecordable
Pulse (bpm) Slight tachycardia 100-120 120, thready >120, very thready
Capillary refill
time
Normal Slow, >2s Slow, >2s Undetectable
Respiratory rate Normal Normal Tachypnea,
>20/min
Tachypnea,
>20/min
Urinary flow rate
(ml/h)
>30 20-30 10-20 0-10
Extremities Color normal Pale Pale Pale and cold
Complexion Normal Pale Pale Ashen
Mental state Alert Anxious or
aggressive
Anxious,
aggressive or
drowsy
Drowsy, confused
or unconscious
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Classification (Blood loss)
Source: ABC of Major Trauma. BMJ.

9. Hemorrhagic hypovolemic shock
-External and internal bleeding

Non hemorrhagic hypovolemic shock
-Severe dehydration or fluid losses
-E.g. in Diabetic Ketoacidosis, Cholera

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Types

10. THANK YOU
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