Shock

Widespread vasodilation, increased capillary permeability, and bronchoconstriction are the result of ___________.

anaphylactic shock

How is blood flow through the capillary beds regulated?

by the capillary sphincters, circular muscular walls that constrict and dilate

What are the circular muscular walls that regulate blood flow through the capillaries?

capillary sphincters

Cardiogenic shock develops when the heart cannot maintain sufficient ________ to meet the demands of the body.

cardiac output

The early stage of shock, in which the body can still compensate for blood loss.

compensated shock

Your patient is in shock, but the body's defense mechanisms are currently able to maintain adequate circulation. This is called _________.

compensated shock

The late stage of shock when blood pressure is falling.

decompensated shock

Vomiting is most likely to cause hypovolemic shock through ________.

depleted volume

A condition that occurs when there is widespread dilation of the small arterioles, small venules, or both.

distributive shock

Abnormal allocation of blood flow with a normal cardiac output is best described as which type of shock?

distributive shock

A 27-year-old man was stabbed in the chest during a disagreement at a poker game. As you approach him, you see that a knife is impaled in his chest. Before you make physical contact with the patient, it is MOST important to:

follow standard precautions

What are the three components of the "perfusion triangle"?

heart, blood vessels, blood

A condition in which low blood volume, due to massive internal or external bleeding or extensive loss of body water, results in inadequate perfusion.

hypovolemic shock

A loss of intravascular fluid volume that results in a decreased cardiac output is best described as which type of shock?

hypovolemic shock

Treat for shock early and aggressively by providing _______ and keeping the patient _______.

oxygen; warm

In order to recognize and treat early shock, the EMT must ___________.

understand the pathophysiology of shock

Distributive shock occurs when:

widespread dilation of the blood vessels causes blood to pool in the vascular beds.

Cardiogenic shock may result from:

a heart attack, increased afterload, or poor contractility.

The force or resistance against which the heart pumps.

afterload

A hypersensitivity reaction that leads to increased capillary permeability is most likely to result in which type of shock?

anaphylactic shock

Foods, medications, and insects are common causes of _______.

anaphylactic shock

What are some conditions that should may you suspect shock?

anaphylaxis, spinal injury, and severe infection.

A 20-year-old male has a large laceration to his wrist. He is holding a blood-soaked towel over the wound, but it continues to bleed rapidly. You should:

apply a tourniquet proximal to the wrist

A construction worker fell approximately 30 feet. He is semiconscious with rapid, shallow respirations. Further assessment reveals deformity to the thoracic region of his spine. His blood pressure is 70/50 mm Hg, his pulse is 66 beats/min and weak, and his skin is warm and dry. In addition to spinal immobilization and rapid transport, the MOST appropriate treatment for this patient includes:

assisted ventilation, thermal management, and elevation of the lower extremities.

When assessing a patient with signs and symptoms of shock, it is important to remember that:

blood pressure may be the last measurable factor to change in shock.

In the cases of poor perfusion, the transportation of ________ out of the tissues becomes impaired, resulting in a buildup of waste products.

carbon dioxide

One of the primary waste products of normal cellular metabolism that must be removed from the body by the lungs is:

carbon dioxide

A state in which not enough oxygen is delivered to the tissues of the body, caused by low output of blood from the heart. It can be a severe complication of a large acute myocardial infarction, as well as other conditions.

cardiogenic shock

Pulmondary edema and impaired ventilation occur during:

cardiogenic shock

Which type of shock is most likely to occur when the heart is unable to pump enough blood to meet the body's metabolic needs?

cardiogenic shock

Your patient has a decreased cardiac output and poor myocardial contractility. This will likely lead to _________.

cardiogenic shock

The term "shock" is most accurately defined as:

cardiovascular collapse leading to inadequate perfusion.

When treating an 80-year-old patient who is in shock, it is important to remember that:

changes in gastric motility may delay gastric emptying, which increases the risk for vomiting.

A blue skin discoloration that is caused by a reduced level of oxygen in the blood.

cyanosis

Loss of water from the tissues of the body.

dehydration

What is nonhemorrhagic cause hypovolemic shock?

diarrhea

The presence of abnormally large amounts of fluid between cells in body tissues, causing swelling of the affected area.

edema

When should nonlifesaving interventions be performed for your multisystem trauma patient?

en route to the hospital

Patients who are known to have anaphylaxis often carry kits with an intramuscular injector or auto-injector containing _______.

epinephrine

A balance of all systems of the body.

homeostasis

Shock is the result of:

hypoperfusion to the cells of the body.

In an acute injury setting, neurogenic shock is commonly accompanied by:

hypothermia

A 20-year-old man was kicked numerous times int eh abdomen during an assault. His abdomen is rigid and tender, his heart rate is 120 beats/min, and his respirations are 30 breaths/min. You should treat this patient for:

hypovolemic shock

Low fluid volume is caused by what type of shock?

hypovolemic shock.

Cardiac tamponade is most likely to cause obstructive shock through what mechanism?

indirect pump failure

Hypotension in a child with blunt or penetrating trauma is particularly significant because:

it often indicates the loss of half of his or her blood volume.

What are the signs and symptoms of Beck's triad?

jugular vein distention, narrowing pulse pressure, and muffled heart sounds.

What is the best pathophysiological description that leads to distributive shock?

lost vascular tone

What is the best pathophysiological description that leads to distributive shock?

low vascular tone

If spinal immobilization is indicated and time allows, splint individual extremity fractures during transport. This accomplishes what?

minimizes pain, prevents the broken bone ends from further damaging adjacent tissue, and minimizes discomfort

The ability of the heart muscle to contract.

myocardial contractility

Circulatory failure caused by paralysis of the nerves that control the size of the blood vessels, leading to widespread dilation; seen in patients with spinal cord injuries.

neurogenic shock

Spinal cord injury that disrupts the sympathetic nervous system is most likely to lead to which type of shock?

neurogenic shock

Cardiac tamponade is an example of which type of shock?

obstructive shock

Shock that occurs when there is a block to blood flow in the heart or great vessels, causing an insufficient blood supply to the body's tissues.

obstructive shock

Which type of shock is most likely to occur when something causes a blockage of blood flow to the heart?

obstructive shock

Once you have assessed ______, determine whether the patient should be treated as a high priority, whether ALS is needed, and which facility to transport to.

perfusion

The flow of blood through body tissues and vessels.

perfusion

A collection of fluid between the pericardial sac and the myocardium.

pericardial effusion

You suspect your patient is in shock. You note the patient's skin is pale. This is likely due to ___________.

peripheral vasoconstriction

Patients develop septic shock secondary to:

poor vessel function and severe volume loss

Anaphylactic shock is caused by:

poor vessel function.

The precontraction pressure in the heart as the volume of blood builds up.

preload

A 59-year-old male presents with severe vomiting and diarrhea of 3 days' duration. He is confused and diaphoretic, and his radial pulses are absent. His blood pressure is 78/50 mm Hg. After applying supplemental oxygen, you should:

prepare for immediate transport

A blood clot that breaks off from a large vein and travels to the blood vessels of the lung causing obstruction of blood flow.

pulmonary embolism

The difference between the systolic and diastolic pressures.

pulse pressure

A myocardial infarction is most likely to cause cardiogenic shock through which mechanism?

pump failure

What are basic physiologic causes of shock?

pump failure, low fluid volume, and poor vessel function.

A 39-year-old man presents with cool and clammy skin, a blood pressure of 88/60 mm Hg, and a fever of 104.5F (40.3C). He has been fighting a bacterial infection for 3 days. Which type of shock do you suspect?

septic shock

A systemic inflammatory response that results in an excessive cellular activation and hypotension despite fluid resuscitation is most likely to lead to which type of shock?

septic shock

Shock caused by severe infection, usually a bacterial infection.

septic shock

Warm skin or fever, tachycardia, and low blood pressures would be signs of which type of shock?

septic shock

What system will assume control of involuntary functions during shock?

sympathetic nervous system

A fainting spell or transient loss of consciousness, often caused by an interruption of blood flow to the brain.

syncope

To protect vital organs, the body compensates by directing blood flow away from organs that are more tolerant of low flow, such as:

the skin

Why is it most important to frequently reassess vital signs for a patient with possible shock?

to observe trends in the patient's condition

Why is adequate perfusion required?

to provide cells oxygen and nutrients and remove waste products

You are on the scene of an unresponsive patient struck by a vehicle. You have completed the primary assessment. What should you do next?

transport the patient

What are signs and symptoms of anaphylactic shock?

wheezing and dyspnea, cyanosis, and urticaria

Severe shock caused by an allergic reaction.

anaphylactic shock

An extreme, life-threatening, systemic allergic reaction that may include shock and respiratory failure.

anaphylaxis

An abnormal enlargement of the wall of a blood vessel that results from the weakening of the vessel wall.

aneurysm

The part of the nervous system that regulates involuntary activities of the body, such as heart rate, blood pressure, and digestion of food.

autonomic nervous system

Hypovelemic shock caused by severe burns is the result of a loss of:

plasma

Shock caused by a sudden, temporary reduction in blood supply to the brain that causes fainting (syncope).

psychogenic shock

Temporary, widespread vasodilation and syncope caused by a sudden nervous system reaction MOST accurately describes:

psychogenic shock

Developing a sensitivity to a substance that initially caused no allergic reaction.

sensitization

What three ways can carbon dioxide be transported in the blood from tissues back to the lungs?

1. Dissolved in the plasma 2. Combined with water in the form of bicarbonate 3. Attached to hemoglobin

The cardiovascular system consists of which three parts?

1. The heart (pump) 2. Blood vessels (container) 3. Blood (content)

As you approach a patient lying at the side of the roadway, you observe severe bleeding from the leg. What should your first action be?

Control the bleeding

What is the ONLY action that can prevent eventual death from a tension pneumothorax?

Decompression of the injured side of the chest