上海交大外科学 休克PBL PPT课件.pptVIP

医学课件 外科休克Shock About myself Name: 费 健 Email: feijian@ Mobile:137-0176-9798 一个例子八大问题 A 22 year old man was driving drunk and without his seatbelt fastened when he was involved in a single-vehicle automobile accident. When attended by EMT（abbr. emergency medical technician 急诊医士） personnel, no information was available about the time of the accident. He was found agitated and complaining of abdominal pain. His airway was patent. At the scene, he was breathing at 20 per minute with a blood pressure of 90/60 and a pulse of 130. He was placed in a hard cervical collar and on a back board and transported to your emergency room. Upon arrival his vital signs are the same, with a temperature of 36oC. His abdomen is markedly distended. His hands and feet are cold, his legs mottled. A nasogastric tube reveals green liquid. A urinary catheter reveals dark yellow urine. His hemoglobin is 7. His abdominal lavage（灌洗）reveals gross blood. Study Questions 1: What type of shock does this patient exhibit?  At the scene, he was breathing at 20 per minute with a blood pressure of 90/60 and a pulse of 130. Upon arrival his vital signs are the same, with a temperature of 36oC. His abdomen is markedly distended. His hands and feet are cold, his legs mottled. A nasogastric tube reveals green liquid. A urinary catheter reveals dark yellow urine. His hemoglobin is 7. His abdominal lavage（灌洗）reveals gross blood. 低血容量性休克 失血性休克 损伤性休克 感染性休克 心源性休克 神经源性休克 过敏性休克 Study Questions 2:  What alterations in oxygen delivery are present?  At the scene, he was breathing at 20 per minute with a blood pressure of 90/60 and a pulse of 130. Upon arrival his vital signs are the same, with a temperature of 36oC. His abdomen is markedly distended. His hands and feet are cold, his