Shock ppt for medical student

Medical and nursing students are use this ppt.

1. Presented By… . Saurabh Kumar BSc(N) 2 nd Year Student

2. Content Introduction Definition Types Pathophysiology Stage Clinical feature Management

3. Introduction Cell need two things to function ; Oxygen and glucose. This allows the cell to generate energy and do their specific jobs. When cell’s don’t receive either of them or both ,they stop function. shock can best be defined as a clinical syndrome that result from inadequate tissue perfusion , creating an imbalance b/w the delivery of oxygen and nutrients needed to support cellular function.

4. Adequate blood flow to the tissue and cells requires an effective cardiac pump, circulatory system and sufficient blood volume. If one of these components is impaired perfusion to the tissue is threatened or compromised. Without treatment , inadequate blood flow to the cells results in poor delivery of oxygen and nutrients , cellular hypoxia , and cell death that progresses to organ dysfunction and eventually death .

5. Definition Shock is a life threatening medical condition in which body suffer from insufficient blood flow throughout the body . It is characterized by inadequate tissue perfusion in which there is insufficient delivery of oxygen and nutrients to the body tissue and inadequate removal of waste product from the tissue , If untreated results in cell death.

6. 3. Types of Shock Cardiogenic Shock Hypovolemic Shock Obstructive Shock Distributive Shock

7. Distributive Shock further classified Anaphylactic Shock Septic shock Neurogenic shock

8. Cardiogenic Shock This type of Shock occur‘s when pumping action of heart diminished and heart fails to pump blood in the body result in decreased cardiac outputs. In cardiogenic Shock ,the left ventricle has been injured in some way , leading to impaired pumping. CAUSE… CAD, MI, Heart Failure..etc

9. Cardiogenic shock signs and symptoms include: Rapid breathing Severe shortness of breath Sudden, rapid heartbeat (tachycardia) Loss of consciousness Weak pulse Low blood pressure (hypotension) Sweating Pale skin Cold hands or feet Urinating less than normal or not at all

10. Medical Management Anti-arrhythmia medicines to restore a regular heartbeat. Blood thinners or antiplatelet medicines to dissolve blood clots and reduce  platelets  that may be blocking the coronary arteries. Vasopressors and inotropes, such as norepinephrine and dobutamine, to increase blood pressure and blood flow out of the heart.

11. Nursing Management Preventing Cardiogenic Shock Monitoring Hemodynamic Status Administering Medication And Intravenous Fluid.

12. Hypovolemic  shock  is an emergency condition in which severe blood or other fluid loss makes the heart unable to pump enough blood to the body. This type of shock can cause many organs to stop working.

13. Causes Losing about one fifth or more of the normal amount of blood in your body causes hypovolemic shock. Blood loss can be due to: Bleeding from cuts Bleeding from other injuries Internal bleeding, such as in the gastrointestinal tract

14. The amount of circulating blood in your body also may drop when you lose too much body fluid from other causes. This can be due to: Burns Diarrhea Excessive perspiration Vomiting

15. Symptoms Anxiety  or agitation Cool, clammy skin Confusion Decreased or no urine output Generalized  weakness Pale skin color  (pallor) Rapid breathing Sweating , moist skin Unconsciousness  (lack of responsiveness)

16. Pathophysiology

17. Medical management Treatment of the underlying cause Fluid and blood replacement Redistribution Of fluid

18. Nursing Management Administering Blood and Fluids Safely Implementing Other Cause

19. 3.

20. Obstructive Shock occur’s when there is a blockage of blood flow in the Cardiovascular circuit outside the heart.

21. Obstructive shock is a medical emergency. It happens when there is a decrease in diastolic filling of the heart, which then decreases cardiac output. This means that the heart is not getting enough blood to pump out to the rest of the body.

22. Shock then occurs due to the lack of blood getting to the organs and decreasing their functioning capacity.

23. Causes of Obstructive Shock Several diseases or disorders can cause obstructive shock, such as: Aortic dissection:   the large blood vessel attached to the heart tears and cannot transport blood to and from the heart effectively. Tension pneumothorax:   air leaks out of the lungs due to trauma.

24. Vena cava syndrome:   a major vein in the body becomes blocked and cannot carry blood from the body to the heart High blood pressure:  pulmonary or systemic hypertension Pulmonary embolism :  blood clot in the lungs

25. Heart lesions :  obstruct the flow of blood from the heart Cardiac tamponade:  a pressure on the heart that keeps it from filling, which decreases blood pressure

26. Symptoms of Obstructive Shock….. 1.Symptoms that are associated with neurological function include, confusion, loss of consciousness, and inability to concentrate.

27. The symptoms that are related to the heart and its function are chest pain, lightheadedness , and a sudden increase in heart rate along with a faint pulse . Respiratory symptoms. c onsist of shortness of breath and fast but shallow breathing .

28. Other symptoms include sweating , decreased urine output, clammy skin, pallor, and cold hands and feet.

29. Nursing Management --- Common interventions include  adequate oxygen, fluid and/or drug therapy . In all cases the nurse needs to provide a safe environment for the patient who may be at risk due to a reducing level of consciousness and deteriorating vital signs.

30. It’s occur when Peripheral Vascular Resistance is lost because of Vasodilation of Peripheral circulation.

31. 3 Types of Distributive Shock. Anaphylactic Shock Septic Shock Neurogenic shock

32. 1. Anaphylactic Shock Anaphylactic shock is a rare but severe  allergic reaction  that can be deadly if you don't treat it right away. It's most often caused by an allergy to food, insect bites, or certain  medications .

33. Shock is when your  blood pressure  drops so low that your cells (and organs) don't get enough oxygen.

34. M ost common causes of an anaphylactic reaction include: Foods, especially nuts and shellfish Latex , found in many disposable gloves, syringes, and adhesive tapes Medications, including penicillin and  aspirin Insect biting

35. Some typical symptoms include: Swelling of your  mouth Tight feeling in your throat and difficulty  breathing Hives Vomiting Dizziness Fainting Rapid heartbeat

36. Management 1 .put a shot of epinephrine under your  skin  or in a muscle or vein.   2. steroids , and  antihistamines  (drugs used to treat allergic reactions) 3. Other possible treatments include a breathing tube and medications to help you breathe better , and a corticosteroid (a powerful anti-inflammatory drug) to keep symptoms from coming back hours later.

37. Septic shock is most often caused by  bacterial infections , but almost any infection can cause septic Shock. There’s a significant drop in blood pressure that can lead to respiratory or heart failure, stroke, dysfunction of other organs, and possibly death.

38. Symptoms . high fever or chills intense body pain fast heart rate rapid breathing rash

39. Management . use a number of medications to treat septic shock, including: intravenous antibiotics to fight infection vasopressor medications, which are drugs that constrict blood vessels and help increase blood pressure insulin  for blood sugar stability corticosteroids

40. Neurogenic shock is a life-threatening condition caused by  irregular blood circulation  in the body.  Trauma  or  injury  to the  spine  can cause this disruption.

41. Neurogenic shock is extremely dangerous because it can cause your  blood pressure to drop  drastically and suddenly, and can leave irreversible damage to your body tissues. If left untreated, neurogenic shock can be fatal.

42. Neurogenic shock symptoms. dizziness nausea vomiting blank stares fainting increased sweating anxiety pale skin

43. In more severe cases of neurogenic shock, you may experience: difficulty breathing chest pain weakness from irregular  blood circulation bradycardia, or a  slower heart rhythm faint pulse cyanosis , or discolored  lips  and  fingers hypothermia , or decreased body temperature

44. If left untreated, neurogenic shock can cause irreversible tissue damage and death. 

45. causes of neurogenic shock include car accidents that cause central nervous system damage or spinal cord injury sport injuries causing trauma to the spine gunshot wounds to the spine

46. medications that affect the autonomic nervous system, which regulates breathing and other automatic bodily functions. improper administration of anesthesia to the spinal cord.

47. Medical Treatment of neurogenic shock norepinephrine epinephrine dopamine vasopressin Atropine( medication will help to keep your  heartbeat normal .)

48. STAGES OF SHOCK Shock is progressive disorder that if uncorrected leads to death.

49. Shock evolves through 3 phases 1.Initial non-progressive phase 2.Progressive phase 3.Irreversible stage

50. 1.Initial non-progressive phase Compensatory mechanism to maintain the homeostasis so that blood supply to  vital organs is maintained By  neuro humoral mechanism  which maintains blood pressure and cardiac output Widespread vasoconstriction of vessels except  coronary and cerebral vessels Fluid conservation by kidney Tachycardia.

51. 2.Progressive phase As the stage advances there is  failure of compensatory mechanism, dilatation of arterioles, veinules and capillary bed Because of this  fluid leaks out of capillaries into interstitium  and there is sludging of blood This  reduces the tissue perfusion  leading to hypoxia Initially body tissue except brain and heart suffers from hypoxia

52. 3.IRREVERSIBLE PHASE (DECOMPENSATED STAGE) Cellular injury and tissue injury is so severe that condition does  not revert back to normal  even after correcting hemodynamic defects Hypoxic and ischemic cell injury –  causes leakage of lysosomal enzymes which further aggravates condition Myocardial infarction and synthesis of NO f urther worsens condition Intestinal ischemia causes microbes from intestinal flora to enter the circulation which produces superimposed bacteremic shoc k Acute tubular necrosis  occurs in kidney

53. Signs and symptoms in different phases

54. Compensated phase 15 to 25% of fluid loss from vessels and there are subtle signs of shock Mean arterial pressure will be less than 10-15mm Hg from the baseline Increased Renin and Anti-diuretic hormon e secretion Vasoconstriction Increased heart rate Decreased pH

55. Progressive phase (Intermediate  phase) 25 to 35% of fluid loss from vessels and classical signs of shock appears Mean arterial pressure is less than 20mmHg from Base line Tissue hypoxia develops Decreased urine output (oliguria) Weak rapid pulse Decreased pH

56. Irreversible phase >35% of fluid loss from vessels, body cells die to hypoxia and vital signs come to bottom. Anuria. Excessive organ or tissue damage. Multi organ failure. Decreased pH. Patient lead to death.