SHOCK

 Q)what is shock?

◦ state of low tissue perfusion that is inadequate for normal cellular respiration  

• insufcient delivery of oxygen and glucose, cells switch from aerobic to anaerobic metabolism  

◦ If perfusion is not restored in a timely fashion----cell death  

Q) Types of shock?

जब तक पता न चले,मान कर चलना है _ Hypovolaemic shock

Classification of shock ○ Haemorrhagic/hypovolaemic shocl ○ Cardiogenic shock ○ Obstructive shock ○ Distributive shock ◦ Endocrine shock  

Q) 3 phase of shock?

Q)clinical features of shock?

9) Traditional classification of haemorrhagic shockis based on

9) Estimated blood loss Based on Patient's Initial Presentation

9)

9) Management of haemorrhage?

Identification of haemorrhage

जब तकBlood न आ जाए, crystall ord देंगे। 

SHOCK RESUSCITATION • patent airway and adequate oxygenation and ventilation. • attention is directed to cardiovascular resuscitation. • Haemorrhagic shock resuscitation should proceed as damage control resuscitation while bleeding continues ◦ After bleeding is controlled, and for all other causes, shock resuscitation is guided by measures of tissue perfusion  

Conduct of resuscitation ◦ initial doubt about the cause of shock, it is safer to assume the cause resuscitation, and then assess the respons S! hypovolaemia and begin with fuid • Correction of shock is important in the pre and peri operative period for all cases of urgent surgery  

Fluid therapy intravenous access and administration of intravenous fuids.  

Monitoring for patients in shock  

Minimum 

 • ECG

 ◦ Pulse oximetry

 ◦ Blood pressure

 ◦ Urine output

Additional modalities   

○ Central venous pressure   ○ Invasive blood pressure   ○ Cardiac output   ○ Base deficit and serum  lactate  

A.

100 students are settled here and there have a sweaty. There are an ensensible water loss, all that water, which is coming out of your body.

Yes, and that's it takes the advantage but a mouth of your density, sort of the manager.

And again, there must be a water that contains electrolytes.

So what is the physiology fluid.

OK, so all of you will go to 3 phases rather than The guest were discontinued the internet also like yesterday.

Go to.

What happened to the brain are, if you want to tell me 

My g. A.

Neurogenic shock...Peripheral pooling increase...venous return decrease...Cardiac output increase...perfusion to the brain decrease....syncope...

Vasovagal syncope....we'll see bradycardia as a symptom 

Q) Bleeding happens but not visible from outside

Kidney, liver, spleen, tearing of mesenteric and ectopic pregnancy 

Q)  In loss of water what happens

Acute water loss

Thirsty, hyponatraemia lethargy,

myoperthy.

Chronic water loss

Q) Investigation in hypovolemic shock

→Blood

→X- Ray

→ CT- scan

→ MRI

→ Nuclear

→ urine

→ Ultrasound