Core Content: Shock

This is core content - you GOTTA know it: SHOCK

There are two main ways that cell is able to generate ATP:

  1. Oxidative phosphorylation: super efficient, requires oxygen
  2. Substrate level phosphorylation: anaerobic; super inefficient, produces lactate --> only thing to do when you have local or systemic cellular hypoxia

There are two primary determinants of oxygen delivery (DO2): Cardiac Output, Arterial O2 Content

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  1. Arterial oxygen content (Arterial O2 sat + Hgb)
  2. Cardiac output (HR x SV) 
    • stroke volume determined by:
      • preload (how much blood is in the ventricle at the end of diastole)
      • afterload (or the force the heart has to pump against)
      • inotropy (how hard the heart is squeezing)

Shock is about oxygen delivery, not necessarily blood pressure.

There are four major categories of shock

  • Hypovolemic --> not enough fluid. Pipes aren't filled

Shock index

HR/SBP. >0.9, helpful for the diagnosis of occult shock https://www.ncbi.nlm.nih.gov/pubmed/23599863/

Occult Causes of non-response to vasopressors

Don't just place CVL and forget about it. http://rebelem.com/occult-causes-of-non-response-to-vasopressors/

RUSH Part I

RUSH Part II

Attribution

“Small Steps" by Lee Rosevere is licensed under CC BY-NC 4.0 / Song has been cropped in length from original form

“Scary Ambient Music (Bloody House)” by TheBoseDeity is licensed under CC BY-NC 3.0 / Song has been cropped in length from original form

ICU Sounds by us

Cold Funk - Funkorama by Kevin MacLeod is licensed under a Creative Commons Attribution license (https://creativecommons.org/licenses/...)
Source: http://incompetech.com/music/royalty-...
Artist: http://incompetech.com/
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