Vince Shared "Week 7: Shock, Sepsis, SIRS, MODS, Burns" - 14 Picmonics
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Week 7: Shock, Sepsis, SIRS, MODS, Burns
Types of Shock
- Hypovolemic
- Depleted Volume
- Cardiogenic
- Pump Failure
- Obstructive
- Indirect Pump Failure
- Distributive
- Lost Vascular Tone
- Neurogenic
- Anaphylactic
- Septic
2 mins
Severe Sepsis and Septic Shock Assessment
- Microthrombi
- DIC
- Decreased Oxygen Saturation
- Decreased WBC
- Oliguria
- High Output Heart Failure
- Multiple Organ Failure
2 mins
Sepsis Assessment
- Signs and Symptoms
- Systemic Infectious Process
- Fever
- Hypotension
- Change in LOC
- Increased WBC
- Shift to the Left
- Tachycardia
- Tachypnea
- Hyperglycemia
- Edema
2 mins
Physiologic Dead Space (VD)
- Tidal Volume (VT)
- Partial pressure of arterial CO2 (PaCO2)
- Partial pressure of CO2 in expired air (PECO2)
- VD = TV x (PaCO2-PECO2) / PaCO2
2 mins
Systemic Inflammatory Response Syndrome (SIRS) Criteria
- Must have 2 or more of the following:
- Temperature < 36C or > 38C
- Pulse > 90 beats per minute
- Respirations > 20/min or PCO2 < 32
- WBC < 4,000 or > 12,000 or 10% bands
- Mechanism
- Subset of Cytokine Storm and Related to Sepsis
2 mins
Disseminated Intravascular Coagulation (DIC) Assessment
- Mechanism
- Improper Initiation of Clotting Cascade
- Signs and Symptoms
- Systemic Bleeding
- Petechiae, Purpura, Ecchymosis
- Change in LOC
- Increased PT and PTT
- Cyanosis
- Increased Fibrin Degradation Products (FDP)
- Decreased Platelets and Fibrinogen
2 mins
Disseminated Intravascular Coagulation (DIC) Interventions
- Complications
- Risk for Shock
- Renal Failure
- Interventions
- Treat Underlying Cause
- Manage Bleeding
- Maintain Fluid and Hemodynamic Balance
- Transfusion
- Oxygenation
- Heparin Drip
2 mins
Rule of 9's for Burns
- Total Body Surface Area (TBSA)
- Head
- Anterior Torso (18%)
- Chest
- Abdomen
- Posterior Torso (18%)
- Upper Back
- Lower Back
- Extremities
- Posterior Leg (each)
- Anterior Leg (each)
- Each Arm
- Genitalia 1%
2 mins
Parkland Formula
- Burn victims
- 24 hours
- TBSA% x Weight x 4 = Fluids
- TBSA %
- x Weight (kg)
- x 4
- = Fluid Requirement (in first 24 hrs)
- Fluids in first 8 hours
- 1/2 of fluid given in first 8 hours
1 min
Types of Burns
- Superficial Thickness
- Sunburn
- Superficial Partial Thickness
- Blisters
- Blanching
- Deep Partial Thickness
- Little or Non-blanching
- Full Thickness
- Waxy White, Yellow or Black
- Decreased Pain
2 mins
Stages of Burn Care
- Phase / Stage 1
- Resuscitative/Emergent Phase
- Injury to Return of Capillary Permeability
- 48-72 hours
- IV Fluid Replacement
- Phase / Stage 2
- Acute Phase
- Diuresis to Near Wound Closure
- Phase / Stage 3
- Wound Closure to Return of Optimal Level
2 mins
Burns Assessment
- Stage and Extent of Burn
- Dyspnea
- Singed Nasal Hairs
- Pain
- Initial Decrease Urinary Output
- Paralytic Ileus
- Signs of Inadequate Hydration
- Shock
- Hypothermia
- Hyperkalemia
2 mins
Burns Interventions
- Ensure Airway Patency
- O2
- IV Fluid Replacement
- Dry Sterile Dressing
- Debridement
- Elevate Burned Limbs
- Analgesics
- Silver Sulfadiazine
- Escharotomy
2 mins
Burns Considerations
- Maintain Body Temperature
- Increased Risk of Infection
- Venous Thromboembolism (VTE) Prophylaxis
- Curling's Ulcer
- Excision and Grafting
- Adequate Nutrition
- Contractures
2 mins
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