Kind of Shock

Shock

- Is the clinical syndrome that occurs when blood circulation in arterial adekuat not meet needed metabolic network.

- Perfusi network depends on 3 factors:
1. Rainfall heart
2. Blood volume
3. Tonus vasomotor perifer

- There are 3 phases of shock:
1. Compensation
2. Progressive
3. Irreversible

Ad. 1. Compensation
- There was a decrease in cardiac output
- Compensation vasokonstriksi with perifer
- Heating Ventilation increased as arterial O2 content down
- Filtrasi glomerolus expenditure decreased to prevent water

Ad. 2. Progressive
- after load heart is not sufficient
- Blood vessel relaxation springter prekapiler, but can not flow to the heart, so that can happen koagulasi intra vein comprehensive (DIC)
- O2 is not enough brain, so that any damage vasomotor and respiration, so that the metabolism so that anaerob make asidosis metabolic consequences lactat acid and carbonic acid increased
- Harass detoksikasi function hepar

Ad. 3 IRREVERSIBLE
- cardiorespirasi system failure, the heart is not able to pump, the lungs become stiff, arising interstitial edema, anoksia hypercarbia
- Cellular damage is too wide, can not be repaired
- Dead

Diagnosis shock Portrait IF
- Decrease sistolik blood pressure> 30 mm Hg
- Alerts perfused network less
- Tachycardia, pus sus weak

the kind of shock:

1. Shock Hipovolemic
a. Because of missing blood / hemorrhagic
- External Hemorrhagic: trauma, hematemesis melena
- Internal Hemorrhagic: hematom, hematothorax, rupture lien
b. Due to missing plasma
- Combustion, peritonitis, DSS
c. Because of lost fluid and electrolyte
- External: vomiting, diarrhea, diabetic acidosis , excessive perspiration
- Internal: pankreasitiss, asites, obstruktif intestine

2. Shock cardiogenik
a. Disritmia
b. Rupture septum ventricle
c. Dysfunction acute valve
d. Failure of heart pump

3. Shock Obstructive
a. Tension pneumothorak
b. Thrombus
c. Miksoma atrial
d. Stenosis

4. Shock Distributive
a. Shock anafilaksis
b. Septic shock
c. Shock neurogenik
d. Vasodilator drugs