SHOCK Clue
Ashley Foster
Created on November 12, 2024
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Transcript
CLUE: SHOCK EDITION
THE CLASSIC EXAM PREP GAME
Miss Scarlet
Colonel Mustard
Mr. Green
Mrs. Peacock
Professor Plum
Mrs. White
_____ IS IN THE _____ STAGE OF SHOCK AND WILL BE TREATED WITH _____
Stages of Shock
Patients
Miss Scarlet
Colonel Mustard
Mr. Green
Mean arterial pressure (MAP) is less than 65
Clue 01
Clue 02
Clue 03
Clue 04
Clue 05
Patient 1
ANSWER
HR is greater than 150 and RR is rapid and shallow
Clue 02
Clue 01
Clue 03
Clue 04
Clue 05
Mean arterial pressure (MAP) is less than 65
Patient 1
ANSWER
Clue 02
Skin is mottled and petechiae can be present along with delayed capillary refill
Clue 03
Clue 01
Clue 04
Clue 05
HR is greater than 150 and RR is rapid and shallow
Mean arterial pressure (MAP) is less than 65
Patient 1
ANSWER
Clue 02
Clue 03
Clue 01
Urine output is very low and patient is lethargic
Clue 04
Clue 05
Skin is mottled and petechiae can be present along with delayed capillary refill
HR is greater than 150 and RR is rapid and shallow
Mean arterial pressure (MAP) is less than 65
Patient 1
ANSWER
Clue 02
Clue 03
Clue 01
Clue 04
Clue 05
Urine output is very low and patient is lethargic
Skin is mottled and petechiae can be present along with delayed capillary refill
HR is greater than 150 and RR is rapid and shallow
Mean arterial pressure (MAP) is less than 65
Metabolic acidosis
Patient 1
HR is >100bpm
Clue 01
Clue 02
Clue 03
Clue 04
Clue 05
Patient 2
ANSWER
Cold and clammy with delayed capillary refill
Clue 02
Clue 01
Clue 03
Clue 04
Clue 05
HR is >100bpm
Patient 2
ANSWER
Clue 02
Decreased urine output
Clue 03
Clue 01
Clue 04
Clue 05
Cold and clammy with delayed capillary refill
HR is >100bpm
Patient 2
ANSWER
Clue 02
Clue 03
Clue 01
Confused and agitated
Clue 04
Clue 05
Decreased urine output
Patient 2
Cold and clammy with delayed capillary refill
HR is >100bpm
ANSWER
Clue 02
Clue 03
Clue 01
Clue 04
Respiratory alkalosis
Clue 05
Confused and agitated
Decreased urine output
Cold and clammy with delayed capillary refill
HR is >100bpm
Patient 2
On medication to help maintain blood pressure within normal limits
Clue 01
Clue 02
Clue 03
Clue 04
Clue 05
Patient 3
ANSWER
Erratic heart rate
Clue 02
Clue 01
Clue 03
Clue 04
Clue 05
Patient 3
On medication to help maintain blood pressure within normal limits
ANSWER
Clue 02
Jaundiced skin and not producing urine
Clue 03
Clue 01
Clue 04
Clue 05
Patient 3
Erratic heart rate
On medication to help maintain blood pressure within normal limits
ANSWER
Clue 02
Clue 03
Clue 01
Intubated with mechanical ventilation; unconscious
Clue 04
Clue 05
Patient 3
Jaundiced skin and not producing urine
Erratic heart rate
On medication to help maintain blood pressure within normal limits
ANSWER
Clue 02
Clue 03
Clue 01
Clue 04
Profound acidosis
Clue 05
Patient 3
Intubated with mechanical ventilation; unconscious
Jaundiced skin and not producing urine
Erratic heart rate
On medication to help maintain blood pressure within normal limits
Patient 1: Miss Scarlet
is in the PROGRESSIVE stage of shock and will be treated with EARLY INTERVENTION as well as cause related interventions
NEXT PATIENT
Patient 2: Colonel Mustard
NEXT PATIENT
is in the COMPENSATORY stage of shock and will be treated with EARLY IDENTIFICATION AND TREATMENT OF THE SPECIFIC CAUSE
Patient 3: Mr Green
is in the IRREVERSIBLE stage of shock and at this point treatments will not work, so 'treatment' will include palliative care consult, comfort related interventions, and meeting with family/caretakers/loved ones
Patient 3: Mr Green
is in the IRREVERSIBLE stage of shock and at this point treatments will not work, so 'treatment' will include palliative care consult, comfort related interventions, and meeting with family/caretakers/loved ones
Types of Shock
____ is in ____ shock and will be treated with ____
Patients
Mrs. White
Colonel Mustard
Mrs. Peacock
Mr. Plum
Mr. Green
Decreased volume and venous return
Clue 01
Clue 02
Clue 03
Clue 04
Clue 05
Patient 1
ANSWER
Decreased tissue perfusion
Clue 02
Clue 01
Clue 03
Clue 04
Clue 05
Decreased volume and venous return
Patient 1
ANSWER
Clue 02
Reduced cardiac output, increased afterload, decreased preload
Clue 03
Clue 01
Clue 04
Clue 05
Decreased tissue perfusion
Decreased volume and venous return
Patient 1
ANSWER
Clue 02
Clue 03
Clue 01
External fluid loss
Clue 04
Clue 05
Reduced cardiac output, increased afterload, decreased preload
Decreased tissue perfusion
Decreased volume and venous return
Patient 1
ANSWER
Clue 02
Clue 03
Clue 01
Clue 04
Internal fluid shift
Clue 05
External fluid loss
Reduced cardiac output, increased afterload, decreased preload
Decreased tissue perfusion
Decreased volume and venous return
Patient 1
Dyspnea, wheezing, stridor, angioedema
Clue 01
Clue 02
Clue 03
Clue 04
Clue 05
Patient 2
ANSWER
Vasodilation
Clue 02
Clue 01
Clue 03
Clue 04
Clue 05
Patient 2
Dyspnea, wheezing, stridor, angioedema
ANSWER
Clue 02
Capillary permeability
Clue 03
Clue 01
Clue 04
Clue 05
Patient 2
Vasodilation
Dyspnea, wheezing, stridor, angioedema
ANSWER
Clue 02
Clue 03
Clue 01
Hypotension, chest pain, sense of impending doom
Clue 04
Clue 05
Patient 2
Capillary permeability
Vasodilation
Dyspnea, wheezing, stridor, angioedema
ANSWER
Clue 02
Clue 03
Clue 01
Clue 04
Flushing, pruritus, anxiety, confusion, dizziness
Clue 05
Patient 2
Dyspnea, wheezing, stridor, angioedema
Vasodilation
Capillary permeability
Hypotension, chest pain, sense of impending doom
Decreased circulation, stroke volume, and cardiac output
Clue 01
Clue 02
Clue 03
Clue 04
Clue 05
Patient 3
ANSWER
Increased preload
Clue 02
Clue 01
Clue 03
Clue 04
Clue 05
Patient 3
Decreased circulation, stroke volume, and cardiac output
ANSWER
Clue 02
Inadequate oxygen supply to the heart and tissues
Clue 03
Clue 01
Clue 04
Clue 05
Patient 3
Increased preload
Decreased circulation, stroke volume, and cardiac output
ANSWER
Clue 02
Clue 03
Clue 01
Angina, arrythmias, fatigue, feelings of impending doom
Clue 04
Clue 05
Patient 3
Inadequate oxygen supply to the heart and tissues
Increased preload
Decreased circulation, stroke volume, and cardiac output
ANSWER
Clue 02
Clue 03
Clue 01
Clue 04
MI can cause this
Clue 05
Patient 3
Angina, arrythmias, fatigue, feelings of impending doom
Inadequate oxygen supply to the heart and tissues
Increased preload
Decreased circulation, stroke volume, and cardiac output
Requires vasopressor to keep MAP greater than 65
Clue 01
Clue 02
Clue 03
Clue 04
Clue 05
Patient 4
ANSWER
Circulatory and cellular metabolism abnormalities
Clue 02
Clue 01
Clue 03
Clue 04
Clue 05
Patient 4
Requires vasopressor to keep MAP greater than 65
ANSWER
Clue 02
Organ dysfunction and tissue hypoperfusion
Clue 03
Clue 01
Clue 04
Clue 05
Patient 4
Circulatory and cellular metabolism abnormalities
Requires vasopressor to keep MAP greater than 65
ANSWER
Clue 02
Clue 03
Clue 01
Increased capillary permeability resulting in edema formation
Clue 04
Clue 05
Patient 4
Organ dysfunction and tissue hypoperfusion
Circulatory and cellular metabolism abnormalities
Requires vasopressor to keep MAP greater than 65
ANSWER
Clue 02
Clue 03
Clue 01
Clue 04
Imbalances in the clotting cascade
Clue 05
Patient 4
Increased capillary permeability resulting in edema formation
Organ dysfunction and tissue hypoperfusion
Circulatory and cellular metabolism abnormalities
Requires vasopressor to keep MAP greater than 65
Vasodilation, bradycardia, hypotension
Clue 01
Clue 02
Clue 03
Clue 04
Clue 05
Patient 5
ANSWER
Decreased cardiac output, circulation, and venous return
Clue 02
Clue 01
Clue 03
Clue 04
Clue 05
Patient 5
Vasodilation, bradycardia, hypotension
ANSWER
Clue 02
Peripheral pooling
Clue 03
Clue 01
Clue 04
Clue 05
Patient 5
Vasodilation, bradycardia, hypotension
Decreased cardiac output, circulation, and venous return
ANSWER
Clue 02
Clue 03
Clue 01
Imbalance between the sympathetic and parasympathethic nervous systems
Clue 04
Clue 05
Patient 5
Peripheral pooling
Decreased cardiac output, circulation, and venous return
Vasodilation, bradycardia, hypotension
ANSWER
Clue 02
Clue 03
Clue 01
Clue 04
Decreased tissue perfusion
Clue 05
Patient 5
Imbalance between the sympathetic and parasympathethic nervous systems
Peripheral pooling
Decreased cardiac output, circulation, and venous return
Vasodilation, bradycardia, hypotension
Patient 1: Mrs. White
Mrs. White is in HYPOVOLEMIC SHOCK and will be treated by STOPPING THE BLEED, FLUID RESUSCITATION, BLOOD PRODUCTS IF NEEDED, AND VASOPRESSORS IF NEEDED
NEXT PATIENT
Patient 2: Mr. Green
Mr. Green is in ANAPHYLACTIC SHOCK and will be treated with EPINEPHRINE, ANTIHISTAMINES, BRONCHODILATORS, FLUID REPLACEMENT, INTUBATION IF NEEDED TO MAINTAIN AIRWAY, AND REMOVING THE CAUSE
NEXT PATIENT
Patient 3: Mr. Plum
Mr. Plum is in CARDIOGENIC SHOCK and will be treated BY TREATING HIS MI (PCI, thrombolytics, CABG)
NEXT PATIENT
Patient 4: Colonel Mustard
Colonel Mustard is in SEPTIC SHOCK and will be treated with QUICK IDENTIFICATION, ANTIBIOTICS, FLUID RESUSCITATION AND VASOPRESSORS, BLOOD TRANSFUSION IF INDICATED, GLUCOSE REGULATION, DVT AND ULCER PROPHYLAXIS, IV SEDATION AND ANALGESIA, CLOSE MONITORING OF LAB VALUES (LACTATE, CULTURES, CBC, METABOLIC PANEL TO INCLUDE KIDNEY AND LIVER FUNCTION TESTS, LIPASE, COAGULATION STUDIES)
NEXT PATIENT
Patient 5: Mrs. Peacock
Mrs. Peacock is in NEUROGENIC SHOCK and will be treated with ATROPINE (TO CORRECT BRADYCARDIA), VASOPRESSORS (HYPOTENSION), AND USE OF SCDs AND AN ABDOMINAL BINDER (FOR VENOUS POOLING)
Picture Links: Stages of Shock
https://www.georgeinstitute.org/media-releases/haemodialysis-unit-preparedness-checklist-developed-to-deliver-safe-dialysis-during
https://thebeaverton.com/2020/09/ally-hospitalized-for-fatigue/
https://x.com/BMJLearning/status/1086965314116612096
https://www.researchgate.net/figure/mage-of-the-second-patient-conscious-with-extensive-periorbital-inflammation-spreading-to_fig1_351953212
https://www.healthonecares.com/healthy-living/blog/a-bridge-to-healing-for-critically-ill-patients-at-tmca
Picture Links: Types of shock
https://www.myheart.org.sg/tag/coronary-artery-disease/
https://craighospital.org/blog/donor-support-helps-craig-grad-regain-her-independence-at-home