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Cardiogenic shock study guide
Cardiogenic shock study guide
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Shock is defined as an insufficient delivery of oxygen to the tissues. To break it down, this means that the amount of oxygen that is required for the body is not being delivered. There are numerous types of shock. The five major types of shock include: cardiogenic shock, obstructive shock, distributive shock, neurogenic shock, anaphylactic shock, psychogenic shock, hypovolemic shock, and respiratory insufficiency shock. The three main causes of shock include reduced blood volume, acute heart conditions, and poor vessel function (RightDiagnosis.com). Reduced blood volume often comes from blood loss; and some examples of acute heart conditions often include heart attacks, arrhythmias, and trauma to heart (Medicine Net). The type of shock that will be discussed in this paper is septic shock which is a type of distributive shock.
Septic shock, also known as sepsis, bacteremic shock, endotoxic shock, and warm shock, occurs as a response to an infection that has spread to the blood and tissue (medline.gov). Any type of fungi, virus, and bacteria can be a cause of the condition.
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As mentioned before, distributive shock is when a person has a normal blood volume, but the blood is not able to circulate properly.
The blood is not able to circulate properly due to the small arterioles, venules, or both dilating too much (Wisegeekhealth.com). There four common types of distributive shock which are septic shock as discussed in the paper, neurogenic shock, and psychogenic shock. Neurogenic shock occurs when a there is a disruption or damage to part of the nervous system that controls size and muscle tone of the blood vessels. Anaphylactic shock, also known as anaphylaxis, is a severe, whole-body allergic reaction to a chemical that has become an allergen (medlineplus.gov). Psychogenic shock is when a patient has a sudden reaction of the nervous system that produces a temporary vascular dilation. (Emergency Care of the Sick and
Cared) Septic shock is an extremely life-threatening condition that is caused by an infection that has spread throughout the blood and tissues. Being that it is such a serious condition, it is important to be aware of the. It is important to know the some of the signs and symptoms, which include warm skin, tachycardia (rapid heart rate), low blood pressure, and respiratory rate higher than 20 breaths a minute. Also, it is incredible to know the treatment and steps to relive the patient which are elevate legs, keep patient warm, oxygen, intravenous therapy, and many more.
It starts as sepsis then progresses to severe sepsis and then septic shock. In the United States alone there are 751,000 cases of severe sepsis a year with a hospital mortality rate of 28.6% or 215,000 deaths a year. For comparison there are 180,000 deaths a year from heart attacks and 200,000 deaths a year from lung or breast cancer (Nguyen et al). When compared to the numbers for diseases that are talked about every day, it is staggering the impact that sepsis has. Not only is it a lethal disease but it is costly as well. Sepsis took up $16.7 billion in national hospital costs (Nguyen et
Sepsis is defined as an exaggerated, overwhelming and uncontrolled systemic inflammatory response to an initially localised infection or tissue injury, which may lead to severe sepsis and septic shock if left untreated (Daniels, 2009; Robson & Daniels, 2013; Dellinger et al, 2013; Perman, Goyal & Gaieski, 2012; Vanzant & Schmelzer, 2011). Septic shock can be classified by acute circulatory failure as a result of massive vasodilation, increased capillary permeability and decreased vascular resistance in the body, causing refractory hypotension despite adequate fluid resuscitation. This leads to irreversible tissue ischaemia, end organ failure and ultimately, death (McClelland & Moxon, 2014; Sagy, Al-Qaqaa & Kim, 2013, Dellinger et al, 2013).
The guidelines’ first focus is the definition of sepsis, which makes sense, because there is no way to effectively treat sepsis without an accurate and categorical definition of the term. The guidelines define sepsis as “the presence (probable or documented) of infection together with systemic manifestations of infection”. Such systemic manifestations can include fever, tachypnea, AMS, WBC >12k, among others; these manifestations are listed in full in Table 1 of the guidelines. The definition for severe sepsis builds on to the definition of sepsis, bringing organ dysfunction and tissue hypoperfusion (oliguria, hypotension, elevated lactate) into the picture; full diagnostic criteria is listed in Table 2. The guidelines recommend that all
The current patient may be experiencing a range of traumatic injuries after his accident, the injuries that the paramedic will focus on are those that are most life threatening. These injuries include: a possible tension pneumothroax or a haemothorax, hypovolemic shock, a mild or stable pelvic fracture and tibia fibula fracture.
Power can be defined as the ability to influence or outright control the behavior of people. A variety of different things can drive power, including both knowledge and experience. Power in most cases is needed to establish authority. In today’s country, the United States government has a lot of power. It has so much power that even American citizens are beginning to complain about it. Having all this power and authority has allowed the government to make decisions quicker. However, by making decisions faster, some mistakes can be made and innocent people can be convicted. This point is directly exemplified when using two New Yorker articles, “Surviving Solitary” and ‘A Shot to The Heart.” Both articles consist of results produced quite
Many great historical figures of the scientific community have written on the subject of the same perplexing disease over the centuries (Angus, van der Poll, Finfer, Vincent 2013). Sepsis has been given many names, origins, and etiologies. In the 4th century, Hippocrates declared the disease the cause of organic decomposition, wound festering, and swamp gas (Angus et al. 2013). During the 19th century, Louis Pasteur theorized the disease was the outcome of a pathogenic microorganism in the bloodstream, which resulted in a body-wide infection (Angus et al. 2013). In the 21st century, the medical community made a breakthrough with the discovery of the disease’s link to the inflammatory response system and devised a plan of action to combat the high mortality rates among those infected (Angus et al. 2013). According to Hotchkiss, Monneret, & Payen (2013) the effects of sepsis are well documented, while the molecular processes it utilizes are still being explored; however, new studies are helping to expand our understanding of the centuries old disease.
An electrocardiogram (ECG) is one of the primary assessments concluded on patients who are believed to be suffering from cardiac complications. It involves a series of leads attached to the patient which measure the electrical activity of the heart and can be used to detect abnormalities in the heart function. The ECG is virtually always permanently abnormal after an acute myocardial infarction (Julian, Cowan & Mclenachan, 2005). Julies ECG showed an ST segment elevation which is the earliest indication that a myocardial infarction had in fact taken place. The Resuscitation Council (2006) recommends that clinical staff use a systematic approach when assessing and treating an acutely ill patient. Therefore the ABCDE framework would be used to assess Julie. This stands for airways, breathing, circulation, disability and elimination. On admission to A&E staff introduced themselves to Julie and asked her a series of questions about what had happened to which she responded. As she was able to communicate effectively this indicates that her airways are patent. Julie looked extremely pale and short of breath and frequently complained about a feeling of heaviness which radiated from her chest to her left arm. The nurses sat Julie in an upright in order to assess her breathing. The rate of respiration will vary with age and gender. For a healthy adult, respiratory rate of 12-18 breaths per minute is considered to be normal (Blows, 2001). High rates, and especially increasing rates, are markers of illness and a warning that the patient may suddenly deteriorate. Julie’s respiratory rates were recorded to be 21 breaths per minute and regular which can be described as tachypnoea. Julies chest wall appeared to expand equally and symmetrical on each side with each breath taken. Julies SP02 levels which are an estimation of oxygen
Sepsis is also called Septicemia and is a poisoning of the blood. This is an attack of bacteria into the bloodstream. Sepsis does not need blood poisoning to occur; it can affect multiple organs or the entire body without it happening. Sepsis is the body’s systematic inflammatory response to a bacterial infection (Jones, 2017). The infection can also have a wound or a chest infection or can be spread throughout the entire body. Sepsis’ definition is “a life-threatening condition that arises when the body’s response to infection injures its own tissues and organs” (McClelland, 2014). Sepsis is a leading cause of hospital admissions and can lead to death in hospital patients worldwide. The death rate associated with
Ryan, E. "A Case of Shell Shock." Canadian Medical Association Journal. 6.12 (1916): 1095-9. Print.
...perfusion and oxygen supply to the brain for few minutes post cardiac arrest resume of reperfusion releases some enzymes which changes intracellular ions and causes cell death.This leads to free radical production, cytotoxic cascade, nitric oxide that ceases further injury to neurons (Nolan et al 2008).Neurological deficit can be a evident post cardiac arrest reperfusion injury however this damage could be alleviated by therapeutic hypothermia recommended by holzer et al (2005). The mechanism of action of therapeutic hypothermia is tought to be mediated by prevention of cerebral reperfusion injury stated by mark luscombe, john c andrezowski (2006) consequently holzer et al ,(2005,2009) suggest if the reperfusion injury occurs following cardiac arrest then it is necessary to use TH to bring to an endto the development of injury and also to overcome the condition.
Blunt force trauma is defined as a traumatic event caused by the introduction of any blunt instrument forcefully, causing injury to the body or head. The Severity of injury is determined by various factors. It may be due to mechanical force such as compression, traction, torsion or shear. Impact of the injury and severity depends on object and movement of victim. Injuries occurred may be internal such as lacerations of internal tissues, organs, fractures of bones or may be external such as abrasion, avulsion, contusion and laceration (Pollak & Saukko, 2009). Severity also depends on anatomical site impacted for ex: Lacerations have irregular margin, hanging causes abrasions, contusions and hyoid bone fractures, Ocular hemorrhages in case of blunt trauma to eyes or Fracture of ribs when hit on chest by a blunt object (Ressel, Hetzel, & Ricci, 2016). Severity is also determined by the duration of time and amount of force applied. Nature of trauma is of importance in forensic medicine. It helps in
Sepsis is defined as a systemic inflammatory response caused by an infective process such as viral, bacterial or fungal (Holling, 2011). Assessment on a patient and starting treatment for sepsis is based on identifying several factors including the infective source, antibiotic administration and fluid replacement (Bailey, 2013). Because time is critical any delay in identifying patients with sepsis will have a negatively affect the patients’ outcome. Many studies have concluded every hour in delay of treatment mortality is increased by 7% (Bailey, 2013). Within this assignment I will briefly discuss the previous practice and the recent practice including the study based on sepsis. I will show what enabled practice to change and I will use the two comparisons of current practice and best practice.
“ Sepsis” according to the International Surviving Sepsis Campaign, is defined as the presence of infection together with systemic manifestations of infection (Dellinger et al., 2013) In todays modern society sepsis still accounts for 15% of maternal deaths a year worldwide (Dolea & Stein, 2003). Despite medical advances, aseptic technique, and antibiotic use, sepsis is the most common cause of direct maternal death in the UK. According to the CMACE report the maternal mortality rate increased from 0.85 deaths per 100,000 maternities in 2003–05 to 1.13 deaths in 2006–08 (Harper, 2011). Puerperal sepsis has a long history within obstetrics and midwifery, and yet despite this knowledge it has become, yet again, the leading cause of direct maternal death. Therefore due to the increased maternal mortality, I have chosen to focus on the care of a woman within ...
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Closing off the jugular veins increasing intracranial and venous pressure. It can lead to lower amounts on air intake and asphyxia. Blocking the carotid arteries depriving the brain of oxygen is another way. Both of these methods can cause a feeling as if your head is going to explode. This is caused by something called a brain attack, which while similar to a heart attack, is different in that the blood builds up against the block causing an increase in pressure in the blood vessels. It can take only 15 seconds for a human to not be able to return naturally from carotid obstruction. Another way in which strangulation can result in immediate medical attention being necessary is pressure on the cardiac sinus. It can cause a slower heart rate or a heart attack. The fourth and final way is the most commonly know one where the airflow is cut off by pressure on the larynx producing asphyxia. It takes four to five minutes of eleven pounds of pressure on the front on the neck to kill a person, though thirty three pounds are needed to close off the trachea completely.Strangulation may have delayed affects such as aspiration, pneumonia, ARDS, and carotid artery dissection. Carotid artery dissection is when an artery tears making it possible for blood to enter the arterial wall. The walls continue splitting possibly leading to a fatal