休克课件_10.ppt

Cardiovascular System Transports oxygen, fuel to cells Removes carbon dioxide, waste products for elimination from body The cardiovascular system is made up of three key elements  Starling’s Law SHOCK Inadequate perfusion (blood flow) leading to inadequate oxygen delivery to tissues Inadequate oxygenation or perfusion causes: Inadequate cellular oxygenation Shift from aerobic to anaerobic metabolism Causes of Inadequate Perfusion Inadequate pump Inadequate preload Poor contractility Excessive afterload Inadequate heart rate Inadequate fluid volume Hypovolemia Inadequate container Excessive dilation Inadequate systematic vascular resistance Maintaining perfusion requires Dependant on 3 components of circulatory system Volume(Fluid) Pump Vessels(Container) Failure of one or more of these causes shock Shock Progressive syndrome Three phases Compensated Decompensated Irreversible Microcirculating changes (1)Microcirculating constrictive phase (compensated shock stage) (2)Microcirculating dilatation phase (uncompensated shock stage) (3)Microcirculating failure phase (irreversible shock stage) Responses to Shock Normal compensation includes: Progressive vasoconstriction Increased blood flow to major organs Increased cardiac output Increased respiratory rate and volume Decreased urine output Compensated Shock Defense mechanisms are successful in maintaining perfusion Presentation Tachycardia Decreased skin perfusion Altered mental status Restlessness, anxiety Earliest sign of shock Compensated Shock Presentation Normal BP, narrow pulse pressure Falling BP = late sign of shock Mild orthostatic hypotension (15 to 25 mm Hg) “Possible” delay in capillary refill Slight tachypnea Respiratory compensation for metabolic acidosis Decompensated Shock Defense mechanisms begin to fail Presentation Hypotension Prolonged Cap refill Marked increase in heart rate Rapid, thready pulse Agitation, restlessness, confusion Decompensated Shock Cardiac Effects De