Dr John Campbell
@campbellteaching·3.3M subscribers·3.1K videos
Shock 5, Management Principles with Priorities in Care
Posted
May 10, 2013
Views
16,843
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May 10, 2013
16,843
168
6
1.03%
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5:26Now PlayingThis is the 5th of 14 sections posted on YouTube. Together they form a complete three hour lecture series on shock. This lecture is designed for students of nursing, medicine and related disciplines. The aim is to understand the physiology and pathophysiology, so we can apply these principles to patient care.
General management principles
The Golden Hour
Establish and maintain a clear airway
Ensure adequate ventilation
Oxygen to keep sats above 95%
Adequate intravenous access
Continuous cardiac monitoring
Urinary catheter
Recording of fluid balance
Central venous monitoring
Physiologically desirable position
Maintain optimum temperature
Blood gases
Acid / base balance assessment
Psychological and family support.
Observation of response to treatment
Inotropes and vasoconstricting drugs
Treatment of underlying disorder
Specific management measures
Hypovolaemic shock
Arrest bleeding
Intravenous fluids
Assess response
Oral rehydration
Treat underlying causes
Diarrhoea and Vomiting in Children
Continue breast feeding
Encourage fluid intake
No fizzy drinks or fruit juice
Oral Rehydration Salts
Consider nasogastric ORS
IVIs for shock or deterioration
Eg. 0.9% saline or saline with 5% glucose
Check Na, K, urea, creatinine, glucose
After rehydration give normal food and milk
Cardiogenic shock
Early thrombolysis
Valve replacement surgery
Correct dysrhythmias
Medications
Obstructive shock
Heparin
Thrombolysis
Pericardiocentesis
Chest decompression
Chest drainage
Septic shock
Initial resuscitation
Cultures
Antibiotics
Correct cause
Vasopressors
Inotropic therapy
Allergic shock
Epinephrine
Adrenaline
Chlorphenamine
Hydrocortisone
Bronchodilators
Oxygen
Fluids
Prevention
Neurogenic shock
Spinal shock
Vasovagal syncope
Psychogenic
Inotropes
Vasopressors
Treat cause
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