Shock is a life-threatening condition that occurs when the body is not getting enough blood flow. The Lack of blood flow means that the cells and organs do not get enough oxygen and nutrients to function properly. Multiple organs can suffer damage as a result
This document discusses the pharmacotherapy of shock. It defines shock and describes the different types including hypovolemic, septic, cardiogenic, anaphylactic, neurogenic, and obstructive shock. The mechanisms of hypovolemic and distributive shock are explained in detail. Fluid replacement options for volume replacement in shock are discussed, including whole blood, plasma, colloids, and crystalloids. Complications of blood transfusion and indications for specific blood products like packed red cells and plasma are also summarized.
This document discusses cardiac glycosides, which are drugs that increase the force of contraction of the heart without increasing oxygen consumption. It specifically focuses on digitalis, which is derived from foxglove. Digitalis increases myocardial contractility in a failing heart, improving cardiac output. It acts by increasing the intracellular calcium levels in cardiac muscle cells. The document covers the chemistry, pharmacology, mechanisms of action, effects on cardiac electrophysiology, pharmacokinetics, uses, and adverse effects of digitalis and other cardiac glycosides in detail over several pages.
Anti-diuretics are substances that inhibit water excretion without affecting salt excretion. They work by reducing urine output. The primary anti-diuretic is anti-diuretic hormone (ADH), also known as vasopressin, which is synthesized in the posterior pituitary and regulates water permeability and absorption in the kidney collecting duct in response to changes in plasma osmolality. ADH acts through V1 receptors in blood vessels and smooth muscle and V2 receptors in the kidney collecting duct to concentrate urine and reduce water excretion. Conditions treated with anti-diuretics include diabetes insipidus and bedwetting. Side effects can include headache, flushing, and hyponatremia.
This document discusses antiarrhythmic drugs used to treat irregular heart rhythms. It begins by defining different types of arrhythmias including bradyarrhythmias, tachyarrhythmias, and heart block. The causes of arrhythmias are then explained as enhanced automaticity, triggered activity, reentry, and fractionation of impulses. Common arrhythmia conditions seen clinically are also outlined. The document then discusses the Vaughan-Williams classification system for antiarrhythmic drugs and provides details on representative drugs from each class, including their mechanisms of action and uses.
The document discusses the heart and hypertension. It defines normal blood pressure and describes the types and causes of hypertension. Hypertension usually has no symptoms, but can sometimes cause headaches, confusion or vision changes. Untreated hypertension can damage blood vessels and the heart over time, so treatment is important even in asymptomatic cases. Treatment includes diuretics, ACE inhibitors, calcium channel blockers, and other drugs that work to lower blood pressure by various mechanisms.
This document discusses various coagulants and anticoagulants. It describes vitamin K and its uses including for prolonged antimicrobial therapy, liver disease, and in newborns. It also discusses other coagulants like fibrinogen, antihemophilic factor, and desmopressin. The document then covers oral anticoagulants like warfarin including its dosing, monitoring, and drug interactions. Newer oral anticoagulants like rivaroxaban and dabigatran are also mentioned. Finally, the document discusses parenteral anticoagulants including unfractionated heparin, low molecular weight heparins, and direct thrombin inhibitors like lepirud
This document summarizes various cardiovascular drugs used to treat cardiac diseases such as hypertension. It discusses major categories including diuretics, ACE inhibitors, calcium channel blockers, beta blockers, and nitrates/nitrites. For each drug class, it describes the mechanisms of action, therapeutic effects, common medications, side effects, nursing considerations and more. The goal is to optimize blood flow and vascular resistance to lower blood pressure.
This document provides information on nonsteroidal anti-inflammatory drugs (NSAIDs) and antipyretic-analgesics. It discusses the classes of NSAIDs including mechanisms of action, therapeutic uses, examples of drugs, and side effects. NSAIDs work by inhibiting cyclooxygenase enzymes and thereby reducing production of prostaglandins involved in inflammation, pain, and fever. The document also reviews antirheumatic drugs for conditions like rheumatoid arthritis, as well as drugs for treating gout such as allopurinol, probenecid, and corticosteroids.
This document discusses the pharmacotherapy of shock. It defines shock and describes the different types including hypovolemic, septic, cardiogenic, anaphylactic, neurogenic, and obstructive shock. The mechanisms of hypovolemic and distributive shock are explained in detail. Fluid replacement options for volume replacement in shock are discussed, including whole blood, plasma, colloids, and crystalloids. Complications of blood transfusion and indications for specific blood products like packed red cells and plasma are also summarized.
This document discusses cardiac glycosides, which are drugs that increase the force of contraction of the heart without increasing oxygen consumption. It specifically focuses on digitalis, which is derived from foxglove. Digitalis increases myocardial contractility in a failing heart, improving cardiac output. It acts by increasing the intracellular calcium levels in cardiac muscle cells. The document covers the chemistry, pharmacology, mechanisms of action, effects on cardiac electrophysiology, pharmacokinetics, uses, and adverse effects of digitalis and other cardiac glycosides in detail over several pages.
Anti-diuretics are substances that inhibit water excretion without affecting salt excretion. They work by reducing urine output. The primary anti-diuretic is anti-diuretic hormone (ADH), also known as vasopressin, which is synthesized in the posterior pituitary and regulates water permeability and absorption in the kidney collecting duct in response to changes in plasma osmolality. ADH acts through V1 receptors in blood vessels and smooth muscle and V2 receptors in the kidney collecting duct to concentrate urine and reduce water excretion. Conditions treated with anti-diuretics include diabetes insipidus and bedwetting. Side effects can include headache, flushing, and hyponatremia.
This document discusses antiarrhythmic drugs used to treat irregular heart rhythms. It begins by defining different types of arrhythmias including bradyarrhythmias, tachyarrhythmias, and heart block. The causes of arrhythmias are then explained as enhanced automaticity, triggered activity, reentry, and fractionation of impulses. Common arrhythmia conditions seen clinically are also outlined. The document then discusses the Vaughan-Williams classification system for antiarrhythmic drugs and provides details on representative drugs from each class, including their mechanisms of action and uses.
The document discusses the heart and hypertension. It defines normal blood pressure and describes the types and causes of hypertension. Hypertension usually has no symptoms, but can sometimes cause headaches, confusion or vision changes. Untreated hypertension can damage blood vessels and the heart over time, so treatment is important even in asymptomatic cases. Treatment includes diuretics, ACE inhibitors, calcium channel blockers, and other drugs that work to lower blood pressure by various mechanisms.
This document discusses various coagulants and anticoagulants. It describes vitamin K and its uses including for prolonged antimicrobial therapy, liver disease, and in newborns. It also discusses other coagulants like fibrinogen, antihemophilic factor, and desmopressin. The document then covers oral anticoagulants like warfarin including its dosing, monitoring, and drug interactions. Newer oral anticoagulants like rivaroxaban and dabigatran are also mentioned. Finally, the document discusses parenteral anticoagulants including unfractionated heparin, low molecular weight heparins, and direct thrombin inhibitors like lepirud
This document summarizes various cardiovascular drugs used to treat cardiac diseases such as hypertension. It discusses major categories including diuretics, ACE inhibitors, calcium channel blockers, beta blockers, and nitrates/nitrites. For each drug class, it describes the mechanisms of action, therapeutic effects, common medications, side effects, nursing considerations and more. The goal is to optimize blood flow and vascular resistance to lower blood pressure.
This document provides information on nonsteroidal anti-inflammatory drugs (NSAIDs) and antipyretic-analgesics. It discusses the classes of NSAIDs including mechanisms of action, therapeutic uses, examples of drugs, and side effects. NSAIDs work by inhibiting cyclooxygenase enzymes and thereby reducing production of prostaglandins involved in inflammation, pain, and fever. The document also reviews antirheumatic drugs for conditions like rheumatoid arthritis, as well as drugs for treating gout such as allopurinol, probenecid, and corticosteroids.
This Presentation covers Pharmacology of different antiplatelet agents their Mechanisms, Kinetics, Therapeutic uses, Adverse drug reactions and also Recent advances ..benefiting the Medical ,Dental graduates..
This document discusses ACE inhibitors, including their mechanism of action, indications for use, adverse effects, and nursing considerations. ACE inhibitors work by inhibiting the angiotensin converting enzyme and reducing vasoconstriction and sodium retention. They are used to treat hypertension, heart failure, myocardial infarction, nephropathy, and diabetes. Common adverse effects include hypotension, cough, and hyperkalemia. Nurses should monitor patients for these effects and educate them about medication use and signs of side effects.
This document discusses different classes of diuretic drugs, including their mechanisms of action, classifications, indications, and side effects. It covers carbonic anhydrase inhibitors, thiazide diuretics, and loop diuretics in detail. Carbonic anhydrase inhibitors work by inhibiting bicarbonate reabsorption in the kidney and are used to treat glaucoma, altitude sickness, and metabolic alkalosis. Thiazide diuretics inhibit sodium reabsorption in the distal convoluted tubule and are used to treat hypertension, heart failure, and kidney stones. Loop diuretics strongly inhibit sodium reabsorption in the thick ascending limb of Henle's loop and are used when a more potent di
An informative but short explanation of one of the important PPI pantoprazole. I hope it will help you to make enough sense about pantoprazole. Be connected with me. Thank you .
Anti-adrenergic drugs work by antagonizing the effects of adrenaline at alpha and beta adrenergic receptors. They are classified as alpha-adrenergic blocking drugs or beta-adrenergic blocking drugs. Alpha blockers are further classified as nonselective, alpha1 selective, or alpha2 selective. They are used to treat conditions like hypertension, benign prostatic hyperplasia, and congestive heart failure. Beta blockers are classified as nonselective or cardioselective. They decrease heart rate and cardiac output, lower blood pressure, and are used to treat hypertension, angina, arrhythmias, and migraines. Common side effects of beta blockers include fatigue, bradycardia
Thiazide diuretics act in the distal convoluted tubule to inhibit sodium reabsorption and promote excretion of sodium, chloride, and water. They are commonly used to treat hypertension and heart failure by reducing extracellular volume. Common thiazide diuretics include hydrochlorothiazide, chlorthalidone, and bendroflumethiazide. Adverse effects include hypokalemia, hyponatremia, hyperglycemia and drug interactions that can be enhanced by their effects on fluid and electrolyte balance. Thiazides must be used cautiously in conditions like pregnancy, diabetes, and renal impairment.
The document discusses various aspects of NSAIDs (Non-Steroidal Anti-Inflammatory Drugs). It defines NSAIDs and describes their analgesic, antipyretic and anti-inflammatory effects. It classifies different types of NSAIDs based on their selectivity for COX-1 and COX-2 enzymes. It also discusses the mechanisms of action, pharmacological properties, uses, doses and adverse effects of several common NSAIDs like aspirin, ibuprofen, ketorolac, diclofenac, celecoxib, paracetamol and nabumetone.
Potassium sparing diuretics work by interfering with sodium reabsorption in the collecting duct of the nephron, thereby inhibiting the indirect secretion of potassium. The main classes are aldosterone antagonists like spironolactone and eplerenone, and epithelial sodium channel inhibitors like amiloride and triamterene. They are used to treat edema and hypertension while preserving potassium levels. Adverse effects include hyperkalemia and hypokalemia, so monitoring of electrolyte levels is important when using these drugs.
Desmopressin
Lypressin
Terlipressin
Felypressin
Argipressin
ornipressin
Desmopressin: It is a selective V2-receptor agonist and is more potent than vasopressin as an antidiuretic. It has negligible vasoconstrictor action. It is administered by oral, nasal and parenteral routes. Lypressin: It acts on both V1- and V2-receptors. It is less potent but longer acting than vasopressin. It is administered parenterally. Terlipressin: It is a prodrug of vasopressin with selective V1 action. It is administered intravenously. Felypressin: It is a synthetic analogue of vasopressin. It is mainly used for its vasoconstrictor (V1 ) action along with local anaesthetics to prolong the duration of action. Felypressin should be avoided in pregnancy because of its oxytocic (uterine stimulant) activity.
This document discusses various classes of oral hypoglycemic agents used to treat type 2 diabetes. It describes insulin secretagogues like sulfonylureas and meglitinides that promote insulin release from the pancreas. Insulin sensitizers like biguanides and thiazolidinediones lower blood sugar by improving insulin response in tissues without stimulating insulin secretion. Alpha-glucosidase inhibitors and DPP-IV inhibitors are also discussed along with their mechanisms of action and examples within each class. Side effects are provided for some of the drug classes.
Nitrates work by relaxing smooth muscle in blood vessels via the production of nitric oxide. This leads to vasodilation and reduced preload and afterload, lowering oxygen demand on the heart. Common side effects include headaches and hypotension. Tolerance develops with chronic use and can be prevented through intermittent dosing schedules and adjunctive treatments that replenish nitric oxide stores. Nitrates are available in various oral, topical, and intravenous formulations for use in angina and heart failure.
The document discusses drugs used in the gastrointestinal system. It covers antiemetics, antidiarrheal drugs, laxatives, gastric acid reducers like antacids, PPIs, and H2 antagonists. It describes the physiology of gastric acid secretion and factors that stimulate or inhibit it. Conditions like hyperacidity, gastritis, and GERD are discussed along with their treatment approaches. The roles of H. pylori and various drug classes in peptic ulcer disease are also summarized.
1. Shock is defined as inadequate tissue perfusion resulting in cellular dysfunction. It can occur with normal or low blood pressure and results from various causes like sepsis, hemorrhage, cardiac failure, etc.
2. Early goal-directed therapy for septic shock involves rapid fluid resuscitation, antibiotics, and vasopressors to maintain adequate perfusion. Dopamine, norepinephrine, and epinephrine are commonly used vasopressors.
3. Cardiogenic shock results from inadequate cardiac output, usually from acute myocardial infarction or myocarditis. It requires fluids, inotropes like dobutamine, and revascularization when possible.
Pharmacology of local aesthetics and its mechanism of action, adverse effects and uses of local aesthetics with a note on the techniques of local aesthetics
The document discusses drugs that act on the uterus. It describes uterine stimulants/oxytocics like oxytocin, ergot alkaloids, and prostaglandins which increase uterine contraction and are used to induce labor or prevent postpartum hemorrhage. It also discusses uterine relaxants/tocolytics like beta-adrenergic agonists, calcium channel blockers, and magnesium sulfate which decrease uterine motility and are used to delay premature labor. The mechanisms, pharmacokinetics, clinical uses and adverse effects of various oxytocic and tocolytic drugs are provided.
This document discusses lipoproteins and drugs that lower lipid levels. It begins by defining lipoproteins and how they transport lipids in blood, classifying them into six groups. It then discusses the functions of different lipoproteins and causes of hyperlipoproteinemias. The document focuses on statins, how they work by inhibiting HMG-CoA reductase, and their effects on cholesterol, LDL, HDL, and triglyceride levels. It covers the pharmacokinetics of statins, their adverse effects and uses. Other drug classes discussed include bile acid sequestrants, fibrates, nicotinic acid and their mechanisms and uses for treating different lipid abnormalities.
The document discusses human renal physiology and diuretics. It covers the key functions of the kidney - filtration, reabsorption, secretion and excretion. It then describes different types of diuretics and how they work, including loop diuretics, potassium sparing diuretics, high ceiling diuretics, osmotic diuretics, thiazide diuretics and carbonic anhydrase inhibitors. Potential side effects of diuretic use are also outlined. The document concludes by discussing antidiuretics like ADH/vasopressin and synthetic forms like desmopressin, as well as lythotriptics and hepatoprotection.
Febrile seizures in emergency departmentTarek Kotb
The document discusses febrile seizures in the emergency department. It defines febrile seizures as seizures associated with fever in children without central nervous system infection. Febrile seizures are classified as simple or complex based on duration, seizure type, and recurrence within 24 hours. Evaluation of febrile seizures includes history, physical exam, and targeted testing depending on age and seizure type. Management focuses on treating the underlying fever or infection. Most children do not require hospitalization after a simple febrile seizure.
A Nursing Simulation: Emergency Department Pain ManagementEnilda Romero-Hall
This document provides an overview of a 3D nursing simulation for emergency department pain management. The simulation allows trainees to take on the role of an emergency room nurse assessing and treating three animated patient cases that vary in ethnicity, age, and emotion. The scenario takes place during a day shift where the patients were injured in a golf cart accident. The simulation was developed using 3D modeling software to create the environment and objects, motion capture for movements, and facial capture to express emotions. It aims to help nursing students and professionals practice correctly identifying patients, evaluating vital signs and pain levels, and determining appropriate pain management plans.
This Presentation covers Pharmacology of different antiplatelet agents their Mechanisms, Kinetics, Therapeutic uses, Adverse drug reactions and also Recent advances ..benefiting the Medical ,Dental graduates..
This document discusses ACE inhibitors, including their mechanism of action, indications for use, adverse effects, and nursing considerations. ACE inhibitors work by inhibiting the angiotensin converting enzyme and reducing vasoconstriction and sodium retention. They are used to treat hypertension, heart failure, myocardial infarction, nephropathy, and diabetes. Common adverse effects include hypotension, cough, and hyperkalemia. Nurses should monitor patients for these effects and educate them about medication use and signs of side effects.
This document discusses different classes of diuretic drugs, including their mechanisms of action, classifications, indications, and side effects. It covers carbonic anhydrase inhibitors, thiazide diuretics, and loop diuretics in detail. Carbonic anhydrase inhibitors work by inhibiting bicarbonate reabsorption in the kidney and are used to treat glaucoma, altitude sickness, and metabolic alkalosis. Thiazide diuretics inhibit sodium reabsorption in the distal convoluted tubule and are used to treat hypertension, heart failure, and kidney stones. Loop diuretics strongly inhibit sodium reabsorption in the thick ascending limb of Henle's loop and are used when a more potent di
An informative but short explanation of one of the important PPI pantoprazole. I hope it will help you to make enough sense about pantoprazole. Be connected with me. Thank you .
Anti-adrenergic drugs work by antagonizing the effects of adrenaline at alpha and beta adrenergic receptors. They are classified as alpha-adrenergic blocking drugs or beta-adrenergic blocking drugs. Alpha blockers are further classified as nonselective, alpha1 selective, or alpha2 selective. They are used to treat conditions like hypertension, benign prostatic hyperplasia, and congestive heart failure. Beta blockers are classified as nonselective or cardioselective. They decrease heart rate and cardiac output, lower blood pressure, and are used to treat hypertension, angina, arrhythmias, and migraines. Common side effects of beta blockers include fatigue, bradycardia
Thiazide diuretics act in the distal convoluted tubule to inhibit sodium reabsorption and promote excretion of sodium, chloride, and water. They are commonly used to treat hypertension and heart failure by reducing extracellular volume. Common thiazide diuretics include hydrochlorothiazide, chlorthalidone, and bendroflumethiazide. Adverse effects include hypokalemia, hyponatremia, hyperglycemia and drug interactions that can be enhanced by their effects on fluid and electrolyte balance. Thiazides must be used cautiously in conditions like pregnancy, diabetes, and renal impairment.
The document discusses various aspects of NSAIDs (Non-Steroidal Anti-Inflammatory Drugs). It defines NSAIDs and describes their analgesic, antipyretic and anti-inflammatory effects. It classifies different types of NSAIDs based on their selectivity for COX-1 and COX-2 enzymes. It also discusses the mechanisms of action, pharmacological properties, uses, doses and adverse effects of several common NSAIDs like aspirin, ibuprofen, ketorolac, diclofenac, celecoxib, paracetamol and nabumetone.
Potassium sparing diuretics work by interfering with sodium reabsorption in the collecting duct of the nephron, thereby inhibiting the indirect secretion of potassium. The main classes are aldosterone antagonists like spironolactone and eplerenone, and epithelial sodium channel inhibitors like amiloride and triamterene. They are used to treat edema and hypertension while preserving potassium levels. Adverse effects include hyperkalemia and hypokalemia, so monitoring of electrolyte levels is important when using these drugs.
Desmopressin
Lypressin
Terlipressin
Felypressin
Argipressin
ornipressin
Desmopressin: It is a selective V2-receptor agonist and is more potent than vasopressin as an antidiuretic. It has negligible vasoconstrictor action. It is administered by oral, nasal and parenteral routes. Lypressin: It acts on both V1- and V2-receptors. It is less potent but longer acting than vasopressin. It is administered parenterally. Terlipressin: It is a prodrug of vasopressin with selective V1 action. It is administered intravenously. Felypressin: It is a synthetic analogue of vasopressin. It is mainly used for its vasoconstrictor (V1 ) action along with local anaesthetics to prolong the duration of action. Felypressin should be avoided in pregnancy because of its oxytocic (uterine stimulant) activity.
This document discusses various classes of oral hypoglycemic agents used to treat type 2 diabetes. It describes insulin secretagogues like sulfonylureas and meglitinides that promote insulin release from the pancreas. Insulin sensitizers like biguanides and thiazolidinediones lower blood sugar by improving insulin response in tissues without stimulating insulin secretion. Alpha-glucosidase inhibitors and DPP-IV inhibitors are also discussed along with their mechanisms of action and examples within each class. Side effects are provided for some of the drug classes.
Nitrates work by relaxing smooth muscle in blood vessels via the production of nitric oxide. This leads to vasodilation and reduced preload and afterload, lowering oxygen demand on the heart. Common side effects include headaches and hypotension. Tolerance develops with chronic use and can be prevented through intermittent dosing schedules and adjunctive treatments that replenish nitric oxide stores. Nitrates are available in various oral, topical, and intravenous formulations for use in angina and heart failure.
The document discusses drugs used in the gastrointestinal system. It covers antiemetics, antidiarrheal drugs, laxatives, gastric acid reducers like antacids, PPIs, and H2 antagonists. It describes the physiology of gastric acid secretion and factors that stimulate or inhibit it. Conditions like hyperacidity, gastritis, and GERD are discussed along with their treatment approaches. The roles of H. pylori and various drug classes in peptic ulcer disease are also summarized.
1. Shock is defined as inadequate tissue perfusion resulting in cellular dysfunction. It can occur with normal or low blood pressure and results from various causes like sepsis, hemorrhage, cardiac failure, etc.
2. Early goal-directed therapy for septic shock involves rapid fluid resuscitation, antibiotics, and vasopressors to maintain adequate perfusion. Dopamine, norepinephrine, and epinephrine are commonly used vasopressors.
3. Cardiogenic shock results from inadequate cardiac output, usually from acute myocardial infarction or myocarditis. It requires fluids, inotropes like dobutamine, and revascularization when possible.
Pharmacology of local aesthetics and its mechanism of action, adverse effects and uses of local aesthetics with a note on the techniques of local aesthetics
The document discusses drugs that act on the uterus. It describes uterine stimulants/oxytocics like oxytocin, ergot alkaloids, and prostaglandins which increase uterine contraction and are used to induce labor or prevent postpartum hemorrhage. It also discusses uterine relaxants/tocolytics like beta-adrenergic agonists, calcium channel blockers, and magnesium sulfate which decrease uterine motility and are used to delay premature labor. The mechanisms, pharmacokinetics, clinical uses and adverse effects of various oxytocic and tocolytic drugs are provided.
This document discusses lipoproteins and drugs that lower lipid levels. It begins by defining lipoproteins and how they transport lipids in blood, classifying them into six groups. It then discusses the functions of different lipoproteins and causes of hyperlipoproteinemias. The document focuses on statins, how they work by inhibiting HMG-CoA reductase, and their effects on cholesterol, LDL, HDL, and triglyceride levels. It covers the pharmacokinetics of statins, their adverse effects and uses. Other drug classes discussed include bile acid sequestrants, fibrates, nicotinic acid and their mechanisms and uses for treating different lipid abnormalities.
The document discusses human renal physiology and diuretics. It covers the key functions of the kidney - filtration, reabsorption, secretion and excretion. It then describes different types of diuretics and how they work, including loop diuretics, potassium sparing diuretics, high ceiling diuretics, osmotic diuretics, thiazide diuretics and carbonic anhydrase inhibitors. Potential side effects of diuretic use are also outlined. The document concludes by discussing antidiuretics like ADH/vasopressin and synthetic forms like desmopressin, as well as lythotriptics and hepatoprotection.
Febrile seizures in emergency departmentTarek Kotb
The document discusses febrile seizures in the emergency department. It defines febrile seizures as seizures associated with fever in children without central nervous system infection. Febrile seizures are classified as simple or complex based on duration, seizure type, and recurrence within 24 hours. Evaluation of febrile seizures includes history, physical exam, and targeted testing depending on age and seizure type. Management focuses on treating the underlying fever or infection. Most children do not require hospitalization after a simple febrile seizure.
A Nursing Simulation: Emergency Department Pain ManagementEnilda Romero-Hall
This document provides an overview of a 3D nursing simulation for emergency department pain management. The simulation allows trainees to take on the role of an emergency room nurse assessing and treating three animated patient cases that vary in ethnicity, age, and emotion. The scenario takes place during a day shift where the patients were injured in a golf cart accident. The simulation was developed using 3D modeling software to create the environment and objects, motion capture for movements, and facial capture to express emotions. It aims to help nursing students and professionals practice correctly identifying patients, evaluating vital signs and pain levels, and determining appropriate pain management plans.
The use of eye movement in the study of emotionally expressive agent in multi...Enilda Romero-Hall
This document discusses the use of eye tracking to study how learners visually attend to emotionally expressive animated agents in multimedia environments. It reviews literature showing that agents can positively impact motivation but also sometimes distract learners or overload them. Few studies have linked agents to higher learning scores or more positive attitudes. The document argues that eye tracking can help validate theories about how humans interact socially with computers and determine how learners process materials. It suggests research on emotionally expressive agents using eye tracking could provide useful information about visual attention and improve agent and material design.
Emergency Department Throughput: Using DES as an effective tool for decision ...SIMUL8 Corporation
This document discusses using discrete event simulation (DES) to support decision making in emergency departments. DES allows modeling of dynamic patient flow and testing of "what if" scenarios. The document outlines best practices for setting up successful DES projects including defining objectives, gathering quality data, validating models, and including frontline staff. Case studies demonstrate how DES has been used at hospitals to evaluate options for capacity changes, process improvements, and reducing wait times.
This document discusses evacuation methods for casualties in combat situations. It describes transportation methods like the four-man carry and the role of the litter team leader. Different types of litters are also outlined, including the Talon II litter, SKED litter, and how to make improvised litters from materials available. The SKED and Talon II litters can be used for land, air, and water evacuations, while improvised litters provide alternatives when standard litters are unavailable. Rapid evacuation is critical for saving lives on the battlefield.
1) Military combat has historically driven advances in pre-hospital emergency medical services (EMS) as lessons learned from treating wounded soldiers were later applied to civilian EMS.
2) Beginning with Napoleon's "flying ambulances", pre-hospital care has evolved from transporting casualties after battles to providing emergency treatment on the battlefield.
3) Recent conflicts in Iraq and Afghanistan further validated and refined Tactical Combat Casualty Care guidelines for pre-hospital trauma care that have also benefited civilian EMS.
This document discusses management of chest trauma. It covers common causes of chest injuries including gunshots, explosions, and crashes. It describes the organs in the chest cavity and how to assess a casualty for chest injuries by examining their breathing, neck, chest wall, and lung sounds. Open and tension pneumothoraces are discussed as well as how to perform a needle decompression in the field to relieve pressure in the chest from a tension pneumothorax. Proper management of chest wounds and decompression of tension pneumothoraces are essential for stabilizing chest trauma patients.
1. The Patient Movement Item (PMI) program provides additional medical equipment solely for sustaining patients during transport between medical facilities.
2. PMI equipment is exchanged one-for-one during evacuations so that patients can remain on life support during transport, while also replenishing treatment teams' supplies.
3. Proper management of PMI inventories, maintenance, and replacements is necessary to ensure medical equipment is available for sustaining casualties during transport.
The Ready Group produces various advanced casualty care kits to save lives by stopping severe bleeding and preventing shock. Their kits range from small self-aid kits to large mass casualty kits and can be customized. The kits contain hemostatic agents, pressure bandages, tourniquets and other supplies to rapidly treat life-threatening bleeding in both civilian and combat situations. The Ready Group also offers evacuation equipment like wheeled stretchers and carts to transport casualties from the point of injury to medical treatment.
This document provides information about Tactical Combat Casualty Care (TCCC) training conducted by Lethics LLC. It outlines the goals of TCCC, which are to treat casualties, prevent additional casualties, and complete the mission. The training includes classroom instruction followed by field exercises evaluating care under fire, tactical field care, and tactical evacuation care. Trainees are graded on critical life-saving skills like hemorrhage control, airway management, and communication during a simulated casualty scenario. The goal is to standardize first aid procedures for operators deploying to hazardous environments.
The patient was stabbed in the left chest and presented with low blood pressure that increased after intravenous fluids but then complained of worsening chest tightness. The document discusses possible causes including internal bleeding, tension pneumothorax, and cardiac tamponade. It outlines signs, symptoms, and investigations for each and management steps including chest tube placement and indications for emergency thoracotomy.
The document provides an overview of Tactical Combat Casualty Care (TCCC) guidelines for treating casualties on the battlefield. It discusses the three goals of TCCC - treat the casualty, prevent additional casualties, and complete the mission. It outlines the M-A-R-C-H-(E) technique for casualty assessment and the three phases of care - Care Under Fire, Tactical Field Care, and Tactical Evacuation Care. Key principles discussed include controlling hemorrhage with tourniquets, wound packing, and pressure bandages. It also reviews airway management techniques such as positioning, nasopharyngeal airways, and identifying airway problems in casualties.
The document discusses the pharmacotherapy of shock, including the pathophysiology, types, and management of shock with a focus on drug therapy. It defines shock and describes the determinants and hemodynamic states involved. The main classes of shock are outlined as hypovolemic, distributive, cardiogenic, and obstructive. Management of shock aims to improve tissue perfusion and oxygenation through the use of inotropic agents to enhance cardiac output and vasopressors or vasodilators to modulate vascular resistance. Dopamine is discussed as having dose-dependent effects including renal and splanchnic vasodilation at low doses and inotropy and vasoconstriction at higher doses.
The document discusses Tactical Combat Casualty Care (TC-3) training for combat medics, which focuses on providing medical care on the battlefield in 3 stages - Care Under Fire, Tactical Field Care, and Combat Casualty Evacuation Care - with an emphasis on controlling hemorrhage, maintaining airways, and fluid resuscitation when possible given limited medical resources and ongoing tactical threats.
Shock is defined as inadequate tissue perfusion resulting from reduced blood flow or oxygen delivery. There are four main types of shock: hypovolemic, cardiogenic, distributive, and obstructive. The management of shock involves treating the underlying cause, restoring circulating volume with intravenous fluids, and providing supportive care such as oxygen supplementation. Goals are to improve oxygen delivery and prevent end organ damage. Early recognition and treatment are important for successful management.
The document provides information on the initial assessment and management of trauma patients using the ABCDE approach. It describes the primary survey process which prioritizes addressing life-threatening issues in the order of: airway and cervical spine protection, breathing and ventilation, circulation, disability, and exposure. Mechanisms of blunt and penetrating trauma are discussed. Specific injuries like tension pneumothorax, hemothorax, and flail chest require interventions like needle decompression or tube thoracostomy during the primary survey to stabilize the patient.
The ABCDE mnemonic is commonly used in first aid training and trauma assessment to prioritize care for a patient. It stands for:
A - Airway, B - Breathing, C - Circulation, D - Disability, E - Exposure/Environment. Variations on the mnemonic order the steps differently or add additional letters to address specific treatments. The recovery position is recommended for any unconscious patient who is still breathing to prevent aspiration.
This document discusses types of shock, including hypovolemic, cardiogenic, obstructive, distributive, septic, anaphylactic, and neurogenic shock. It covers the pathophysiology, signs and symptoms, treatment principles of fluid resuscitation, and choices of intravenous fluids for each type of shock. The key aspects of fluid management in shock include initially restoring intravascular volume with crystalloids before considering colloids or blood transfusion to achieve hemodynamic goals.
The document provides information on combat lifesaver (CLS) techniques for treating wounded soldiers under fire or on the battlefield. It describes how applying tourniquets and treating tension pneumothorax can save lives by stopping severe bleeding and relieving air from the chest cavity. Proper care and evacuation of wounded soldiers can prevent 15% of combat deaths from occurring before reaching a medical facility.
Cardiogenic shock is a life-threatening condition where the heart is unable to pump enough blood to meet the body's needs. It is usually caused by heart muscle damage from a myocardial infarction, cardiomyopathy, or other acute cardiac conditions. Key features include low blood pressure, rapid heart rate, impaired thinking, and poor peripheral circulation. Treatment focuses on supporting heart function through inotropic drugs or devices, reducing workload on the heart, and treating any underlying causes.
Shock is a life-threatening condition caused by not enough blood flow to organs. The main types are hypovolemic from blood/fluid loss, cardiogenic from heart issues, anaphylactic from allergic reactions, and septic from infections. Hypovolemic shock treatments replace lost fluids while septic shock treatments identify and treat infections through antibiotics and fluids. All types of shock require immediate medical care to stabilize the patient and restore blood flow.
Shock is a life-threatening condition characterized by reduced blood flow and tissue hypoperfusion. It can progress through compensated, decompensated, and irreversible stages if not treated immediately. The key signs of shock include pallor, sweating, tachycardia, and low blood pressure. The main types of shock are hypovolemic, cardiogenic, septic, anaphylactic, neurogenic, and traumatic. Immediate treatment focuses on identifying and treating the underlying cause, restoring intravascular volume with intravenous fluids, and supporting blood pressure and organ function with vasopressors if needed.
The document discusses different types of shock and their causes, signs, and treatments. It defines shock as a life-threatening condition caused by not enough blood flow to organs and cells. The five main types of shock covered are cardiogenic, hypovolemic, anaphylactic, septic, and neurogenic. Hypovolemic shock, caused by blood or fluid loss, is the most common type. Anaphylactic shock results from severe allergic reactions and requires immediate epinephrine treatment to raise blood pressure. Left untreated, any type of shock can rapidly lead to organ damage or death.
Shock is a life-threatening condition where the body's tissues do not receive enough blood flow and oxygen. There are several types of shock including cardiogenic, hypovolemic, obstructive, and distributive shock. Distributive shock includes anaphylactic, septic, and neurogenic shock. Shock progresses through initial, progressive, and irreversible stages characterized by worsening signs and symptoms as compensatory mechanisms fail. Treatment depends on the underlying cause but aims to restore adequate blood flow and oxygen delivery to tissues.
This document discusses various circulatory system complications including varicose veins, hypertension, hypotension, atherosclerosis, shock, heart attack, and stroke. It defines each condition, describes common symptoms and causes, and outlines treatment approaches. The goal is for students to distinguish between different circulatory disorders, explain how diseases occur and are treated, and increase awareness to help prevent issues.
shock and its medicine treatment type nursing related questionswajidullah9551
Shock is a life-threatening condition caused by low blood flow and oxygen delivery to organs. It can result from issues like blood loss, heart problems, medication side effects, or allergic reactions. Signs include weak pulse, rapid breathing, pale skin, low blood pressure and loss of consciousness. There are four main types - hypovolemic from blood/fluid loss, cardiogenic from heart issues, obstructive from blocked blood flow, and distributive from dilated blood vessels. Treatment focuses on laying the person flat, providing CPR if needed, treating injuries, keeping them warm and comfortable, and further evaluation and care in the hospital.
Shock is a life-threatening medical condition where the body is not getting enough blood flow. There are several types of shock including hypovolemic, cardiogenic, and distributive shock. Cardiogenic shock occurs when the heart cannot pump enough blood due to conditions like a heart attack. It can lead to organ damage and death if not treated promptly with interventions like medications, angioplasty, stents, or surgery. Nurses monitor vital signs closely and watch for signs of fluid overload in patients experiencing cardiogenic shock.
1. Shock is defined as a state of low tissue perfusion resulting from inadequate oxygen and glucose delivery to cells. This causes cells to switch from aerobic to anaerobic metabolism, leading to cell death if not corrected.
2. The pathophysiology of shock involves simultaneous cellular, microvascular, and systemic changes including metabolic acidosis, organ ischemia, immune system activation, and sympathetic nervous system response.
3. Shock is classified based on its underlying cause as hypovolemic, cardiogenic, obstructive, distributive, or endocrine. Resuscitation priorities include addressing hypovolaemia with intravenous fluids before considering further treatment.
power point presentation on shock management.pptxAregashAcha
Shock is a medical emergency characterized by inadequate tissue perfusion leading to cellular dysfunction. It can be caused by issues related to blood volume, cardiac function, vasodilation, or obstruction of blood flow. The main goals in treatment are to restore circulating volume and tissue perfusion through intravenous fluids, blood products, vasopressors if needed, and treating the underlying cause. Early recognition and treatment are important to prevent multiple organ failure and death.
Pulmonary edema is an abnormal buildup of fluid in the lungs causing shortness of breath. It can be caused by conditions affecting the heart like heart failure, heart attack, or heart valve problems. Symptoms include cough, trouble breathing, and anxiety. Diagnosis involves listening to the lungs, blood tests, chest x-ray, and echocardiogram. Treatment is focused on relieving symptoms like giving oxygen, using diuretics to remove fluid, and treating the underlying cause. Nursing care focuses on monitoring the patient, administering medications, educating on treatment and preventing future episodes.
This document discusses shock, its causes, pathophysiology, classification, stages, signs and symptoms, diagnosis, treatment and nursing management. Shock is defined as a life-threatening condition characterized by inadequate tissue perfusion. It can result from reduced blood volume, heart malfunction, lung issues, or other causes. Shock progresses through compensatory, progressive and irreversible stages. Treatment involves restoring blood volume, increasing cardiac output, treating underlying causes, and supportive nursing care.
Shock is a life-threatening condition where tissues do not receive adequate oxygen due to low blood flow. There are three stages of shock: compensatory, progressive, and refractory. Shock can be classified as hypovolemic, cardiogenic, neurogenic, anaphylactic, or septic depending on the cause. Treatment focuses on restoring adequate circulation through fluid resuscitation, vasopressors, or inotropes while also treating the underlying cause of shock.
Presentation on clinical signs of hypovolemic shock and the best ways to approach stabilizing these patients before sending them on to a referral center with more sophisticated equipment for treating such cases.
This document provides an overview of shock in children, including:
1. Definitions of shock and the pathophysiology involving reduced tissue perfusion and oxygen delivery.
2. The epidemiology and classifications of different shock types, including hypovolemic, distributive, cardiogenic, and obstructive shock.
3. Details on the causes, signs, symptoms, and stages of specific shock types like septic, hemorrhagic, and cardiogenic shock.
4. The goals of evaluating and managing shock in children, including rapid assessment of appearance, breathing, circulation, history, and physical exam findings.
Shock is defined as a physiological state with reduced tissue perfusion and oxygen delivery. It can be caused by various conditions that prevent the circulatory system from meeting metabolic demands. The main types of shock are hypovolemic, cardiogenic, obstructive, distributive, and septic shock. Treatment involves identifying the underlying cause, restoring circulating blood volume, and supporting vital organ function.
This document provides an overview of various medical conditions that are relevant for the prevention and care of athletic injuries, including:
1. Cardiovascular conditions like hypertension, hypotension, sudden cardiac death from conditions like hypertrophic cardiomyopathy, and non-cardiac causes like substance abuse.
2. Blood and lymph disorders such as anemia, sickle cell anemia, hemophilia, and lymphangitis.
3. Neurological conditions including headaches, seizure disorders, meningitis, and encephalitis.
4. Respiratory tract infections and conditions affecting the upper respiratory tract and lungs, like the common cold, sinusitis, bronchitis, and asthma.
This document contains personal information including a name, date of birth, and date. It lists Tyshon Marthone Kaylin Butler as the name and provides his date of birth as well as the date this document was generated or last updated, which is February 17, 2016. In summary, this brief document contains basic identifying information for an individual along with a date.
Optimal health refers to an individual's physical, emotional, and mental well-being and their ability to achieve personal health goals. Chronic conditions are long-lasting medical issues that can be managed but not cured, and they are the leading cause of death and disability in the U.S. Maintaining optimal health through good nutrition, physical activity, and lifestyle habits can help prevent chronic conditions and allow those with chronic conditions to experience fewer symptoms and a lower risk of additional health issues. However, adapting new health behaviors requires commitment over the long-term.
Their universal health care system is based on the principles of Bismark, which say that the state should provide only for those unable to provide for themselves. It’s a private insurance system, and it’s the topic of this powerpoint
This document provides information on Dissociative Identity Disorder (DID), formerly known as Multiple Personality Disorder. It discusses skepticism around DID and explains that dissociation exists on a spectrum from mild daydreaming to more severe identity fragmentation. The document outlines characteristics of DID like disturbances in identity, existence of distinct alters, and types of relationships between alters. Causes like childhood trauma and abuse are explored, as are popular portrayals of DID in films and books. Assessment tools, integration in therapy, and two case studies of individuals with DID are summarized.
This document discusses coronary artery disease (CAD) and its treatment through angiography. CAD is caused by a buildup of plaque in the coronary arteries that supply the heart with blood. When plaque builds up, it reduces blood flow to the heart and can cause chest pain known as angina. Angiography is a medical imaging technique used to visualize the blood vessels by injecting contrast dye and taking X-rays. It is commonly used to diagnose and develop treatment plans for patients with CAD. The document then provides details on a nursing care plan for managing acute chest pain, one of the most common symptoms of CAD seen in hospitals. The plan includes assessing pain levels, providing comfort measures, administering medications, and educating the patient
A colostomy is a surgical procedure that brings part of the large intestine out through an opening in the abdominal wall. It may be temporary or permanent and is usually performed after bowel surgery or injury. Different types of colostomies include colostomies, ileostomies, and urostomies, which are named based on where in the digestive tract the opening is created. Proper care and maintenance of a colostomy involves cleaning the skin around the stoma with wipes, checking it regularly with a mirror, and applying new appliances securely.
Breast cancer :Receptor (ER/PR/HER2 NEU) Discordance.pptxDr. Sumit KUMAR
Receptor Discordance in Breast Carcinoma During the Course of Life
Definition:
Receptor discordance refers to changes in the status of hormone receptors (estrogen receptor ERα, progesterone receptor PgR, and HER2) in breast cancer tumors over time or between primary and metastatic sites.
Causes:
Tumor Evolution:
Genetic and epigenetic changes during tumor progression can lead to alterations in receptor status.
Treatment Effects:
Therapies, especially endocrine and targeted therapies, can selectively pressure tumor cells, causing shifts in receptor expression.
Heterogeneity:
Inherent heterogeneity within the tumor can result in subpopulations of cells with different receptor statuses.
Impact on Treatment:
Therapeutic Resistance:
Loss of ERα or PgR can lead to resistance to endocrine therapies.
HER2 discordance affects the efficacy of HER2-targeted treatments.
Treatment Adjustment:
Regular reassessment of receptor status may be necessary to adjust treatment strategies appropriately.
Clinical Implications:
Prognosis:
Receptor discordance is often associated with a poorer prognosis.
Biopsies:
Obtaining biopsies from metastatic sites is crucial for accurate receptor status assessment and effective treatment planning.
Monitoring:
Continuous monitoring of receptor status throughout the disease course can guide personalized therapy adjustments.
Understanding and managing receptor discordance is essential for optimizing treatment outcomes and improving the prognosis for breast cancer patients.
Applications of NMR in Protein Structure Prediction.pptxAnagha R Anil
This presentation explores the pivotal role of Nuclear Magnetic Resonance (NMR) spectroscopy in predicting protein structures. It delves into the methodologies, advancements, and applications of NMR in determining the three-dimensional configurations of proteins, which is crucial for understanding their function and interactions.
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Congestive Heart failure is caused by low cardiac output and high sympathetic discharge. Diuretics reduce preload, ACE inhibitors lower afterload, beta blockers reduce sympathetic activity, and digitalis has inotropic effects. Newer medications target vasodilation and myosin activation to improve heart efficiency while lowering energy requirements. Combination therapy, following an assessment of cardiac function and volume status, is the most effective strategy to heart failure care.
CLASSIFICATION OF H1 ANTIHISTAMINICS-
FIRST GENERATION ANTIHISTAMINICS-
1)HIGHLY SEDATIVE-DIPHENHYDRAMINE,DIMENHYDRINATE,PROMETHAZINE,HYDROXYZINE 2)MODERATELY SEDATIVE- PHENARIMINE,CYPROHEPTADINE, MECLIZINE,CINNARIZINE
3)MILD SEDATIVE-CHLORPHENIRAMINE,DEXCHLORPHENIRAMINE
TRIPROLIDINE,CLEMASTINE
SECOND GENERATION ANTIHISTAMINICS-FEXOFENADINE,
LORATADINE,DESLORATADINE,CETIRIZINE,LEVOCETIRIZINE,
AZELASTINE,MIZOLASTINE,EBASTINE,RUPATADINE. Mechanism of action of 2nd generation antihistaminics-
These drugs competitively antagonize actions of
histamine at the H1 receptors.
Pharmacological actions-
Antagonism of histamine-The H1 antagonists effectively block histamine induced bronchoconstriction, contraction of intestinal and other smooth muscle and triple response especially wheal, flare and itch. Constriction of larger blood vessel by histamine is also antagonized.
2) Antiallergic actions-Many manifestations of immediate hypersensitivity (type I reactions)are suppressed. Urticaria, itching and angioedema are well controlled.3) CNS action-The older antihistamines produce variable degree of CNS depression.But in case of 2nd gen antihistaminics there is less CNS depressant property as these cross BBB to significantly lesser extent.
4) Anticholinergic action- many H1 blockers
in addition antagonize muscarinic actions of ACh. BUT IN 2ND gen histaminics there is Higher H1 selectivitiy : no anticholinergic side effects
Storyboard on Acne-Innovative Learning-M. pharm. (2nd sem.) CosmeticsMuskanShingari
Acne is a common skin condition that occurs when hair follicles become clogged with oil and dead skin cells. It typically manifests as pimples, blackheads, or whiteheads, often on the face, chest, shoulders, or back. Acne can range from mild to severe and may cause emotional distress and scarring in some cases.
**Causes:**
1. **Excess Oil Production:** Hormonal changes during adolescence or certain times in adulthood can increase sebum (oil) production, leading to clogged pores.
2. **Clogged Pores:** When dead skin cells and oil block hair follicles, bacteria (usually Propionibacterium acnes) can thrive, causing inflammation and acne lesions.
3. **Hormonal Factors:** Fluctuations in hormone levels, such as during puberty, menstrual cycles, pregnancy, or certain medical conditions, can contribute to acne.
4. **Genetics:** A family history of acne can increase the likelihood of developing the condition.
**Types of Acne:**
- **Whiteheads:** Closed plugged pores.
- **Blackheads:** Open plugged pores with a dark surface.
- **Papules:** Small red, tender bumps.
- **Pustules:** Pimples with pus at their tips.
- **Nodules:** Large, solid, painful lumps beneath the surface.
- **Cysts:** Painful, pus-filled lumps beneath the surface that can cause scarring.
**Treatment:**
Treatment depends on the severity and type of acne but may include:
- **Topical Treatments:** Such as benzoyl peroxide, salicylic acid, or retinoids to reduce bacteria and unclog pores.
- **Oral Medications:** Antibiotics or oral contraceptives for hormonal acne.
- **Procedures:** Such as chemical peels, extraction of comedones, or light therapy for more severe cases.
**Prevention and Management:**
- **Cleanse:** Regularly wash skin with a gentle cleanser.
- **Moisturize:** Use non-comedogenic moisturizers to keep skin hydrated without clogging pores.
- **Avoid Irritants:** Such as harsh cosmetics or excessive scrubbing.
- **Sun Protection:** Use sunscreen to prevent exacerbation of acne scars and inflammation.
Acne treatment can take time, and consistency in skincare routines and treatments is crucial. Consulting a dermatologist can help tailor a treatment plan that suits individual needs and reduces the risk of scarring or long-term skin damage.
Part III - Cumulative Grief: Learning how to honor the many losses that occur...bkling
Cumulative grief, also known as compounded grief, is grief that occurs more than once in a brief period of time. As a person with cancer, a caregiver or professional in this world, we are often met with confronting grief on a frequent basis. Learn about cumulative grief and ways to cope with it. We will also explore methods to heal from this challenging experience.
TEST BANK For Brunner and Suddarth's Textbook of Medical-Surgical Nursing, 14...Donc Test
TEST BANK For Brunner and Suddarth's Textbook of Medical-Surgical Nursing, 14th Edition (Hinkle, 2017) Verified Chapter's 1 - 73 Complete.pdf
TEST BANK For Brunner and Suddarth's Textbook of Medical-Surgical Nursing, 14th Edition (Hinkle, 2017) Verified Chapter's 1 - 73 Complete.pdf
TEST BANK For Brunner and Suddarth's Textbook of Medical-Surgical Nursing, 14th Edition (Hinkle, 2017) Verified Chapter's 1 - 73 Complete.pdf
congenital GI disorders are very dangerous to child. it is also a leading cause for death of the child.
this congenital GI disorders includes cleft lip, cleft palate, hirchsprung's disease etc.
A congenital heart defect is a problem with the structure of the heart that a child is born with.
Some congenital heart defects in children are simple and don't need treatment. Others are more complex. The child may need several surgeries done over a period of several years.
2. Shock is a life-threatening condition that occurs when
the body is not getting enough blood flow. The Lack
of blood flow means that the cells and organs do not
get enough oxygen and nutrients to function properly.
Multiple organs can suffer damage as a result.
4. Cardiogenic shock is a condition where the heart has
been damaged so much that it is unable to supply
enough blood to the organs of the body.
The most common causes are serious heart
complications. These complications include:
Pressure on the heart due to a buildup of fluid
around it
Tear or rupture of the muscles or tendons that
support the heart valves, especially the mitral
valve
Very slow heart rhythm or problem with the
electrical system of the heart
5. Chest pain or pressure
Coma
Decreased urination
Fast breathing
Fast pulse
Heavy sweating, moist skin
Lightheadedness
Loss of alertness and ability to
concentrate
Restlessness, agitation, confusion
Shortness of breath
Skin that feels cool to the touch
Pale skin color or blotchy skin
Weak (thready) pulse
6. Hypovolemic shock is an emergency condition in which severe blood
and fluid loss make the heart unable to pump enough blood to the
body.
Causes: Losing about a fifth or more of the normal amount of blood in
your body causes hypovolemic shock.
Blood loss can be due to:
Bleeding from cuts
Bleeding from other injuries
Internal bleeding, such as in the gastrointestinal tract
The amount of circulating blood in your body may drop when you
lose too many other body fluids. This can be due to:
Burns
Diarrhea
Excessive perspiration
Vomiting
7. Anxiety or agitation
Cool, clammy skin
Confusion
Decreased or no urine
output
General weakness
Pale skin color (pallor)
Rapid breathing
Sweating, moist skin
Unconsciousness
8. Anaphylactic shock is a severe, whole-body
allergic reaction to a chemical that
has become an allergen.
Common anaphylaxis triggers include:
(depending what you are allergic to)
Certain medications, especially
penicillin
Foods, such as peanuts, tree nuts
(walnuts, pecans, almonds,
cashews), wheat (in children), fish,
shellfish, milk and eggs
Insect stings from bees, yellow
jackets, wasps, hornets and fire ants
9. Septic shock is a serious condition that occurs when a
body-wide infection leads to dangerously low blood
pressure.
Sepsis can be caused by any type of infection:
bacterial, fungal, or viral. Sepsis commonly originates
from:
abdominal or digestive system infections
lung infections like pneumonia, bronchitis, or
lower respiratory tract infections, which are
responsible for around 25 percent of cases (NHS)
urinary tract infection
reproductive system infection
10. Cool, pale arms and legs
High or very low
temperature, chills
Light-headedness
Little or no urine
Low blood pressure,
especially when standing
Palpitations
Rapid heart rate
Restlessness, agitation,
lethargy, or confusion
Shortness of breath
Skin rash or discoloration
11. Overall Goal of Shock
management is the
restoration of adequate
perfusion; to restore
perfusion center on
achieving an adequate blood
pressure, increasing cardiac
output, and or optimizing
the oxygen content of blood;
in order to prevent cellular
and organ injury.
Restoration of hemodynamic
stability should be a priority
while simultaneous efforts to
treat the cause of shock care
implemented.
13. Electrocardiographic
BP with an arterial catheter
Pulse Oximetry
central venous pressure
renal perfusion concentration of
lactate
*Depending on the etiology of the shock will guide you on what specific vital signs
to focus on.
14. Vasoactive medications are frequently used in the
emergency management of shock to increase mean arterial
blood pressure (MAP) and restore organ perfusion and
oxygen delivery. Classically, these medications are
administered when intravenous fluid resuscitation fails to
restore adequate oxygen delivery.
15. Inotropic agent any of a
class of agents affecting
the force of muscle
contraction, particularly a
drug affecting the force of
cardiac contraction;
positive inotropic agents
increase, and negative
inotropic agents decrease
the force of cardiac muscle
contraction.
16. Norepinephrine is similar to
adrenaline. It works by
constricting (narrowing) the
blood vessels and increasing
blood pressure and blood
glucose (sugar) levels.
Norepinephrine is used to treat
life-threatening low blood
pressure (hypotension) that can
occur with certain medical
conditions or surgical
procedures. This medication is
often used during CPR (cardio-pulmonary
resuscitation).
17. Norepinephrine is injected
into a vein through an IV.
Norepinephrine is usually
given for as long as needed
until your body responds to
the medication. Some people
must receive norepinephrine
for several days.
Your blood pressure,
breathing, and other vital
signs will be watched closely
while you are receiving
norepinephrine.
18. Epinephrine is a chemical that narrows blood vessels and
opens airways in the lungs. These effects can reverse
severe low blood pressure, wheezing, severe skin itching,
hives, and other symptoms of an allergic reaction.
Epinephrine injection is used to treat severe allergic
reactions (anaphylaxis) to insect stings or bites, foods,
drugs, and other allergens. Epinephrine is also used to
treat exercise-induced anaphylaxis.
19. Dobutamine stimulates heart muscle and improves blood flow by helping
the heart pump better.
Dobutamine is used short-term to treat cardiac decompensation due to
weakened heart muscle.
Dobutamine is usually given after other heart medicines have been tried
without success.
Dobutamine is injected into a vein through a catheter. You will receive this
medicine in a hospital or clinic setting to quickly treat any serious side effects
that occur. While using dobutamine, you may need frequent medical tests.
Your heart function may need to be checked using an electrocardiograph or
ECG (sometimes called an EKG).
20. Dopamine injection (Intropin) is used to treat certain
conditions, such as low pressure, that occur when you are in
shock, which may be caused by heart attack, trauma, surgery,
heart failure, kidney failure, and other serious medical
conditions.
Dopamine injection is injected into a vein through an IV.
Your breathing, blood pressure, oxygen levels, kidney
function, and other vital signs will be watched closely while
you are receiving dopamine.
21. Intravenous therapy is used to correct electrolyte
imbalances, to deliver medications, for blood
transfusion or as fluid replacement to correct, for
example, dehydration.
22. There are two main types of volume expander; crystalloids and colloids. Crystalloids
are aqueous solutions of mineral salts or other water-soluble molecules. Colloids
contain larger insoluble molecules, such as gelatin. Blood is a colloid.
Colloids preserve a high colloid osmotic pressure in the blood, while, on the other
hand, this parameter is decreased by crystalloids due to hemodilution. Crystalloids
generally are much cheaper than colloids. (blood, albumin, plasma, etc.)
The most commonly used crystalloid fluid is normal saline, a solution of sodium
chloride at 0.9% concentration, which is close to the concentration in the blood
(isotonic). Lactated Ringer's (also known as Ringer's lactate) and the closely related
Ringer's acetate, are mildly hypotonic solutions often used in those who have
significant burns (normal saline, ringer lactate, dextrose, etc.)
23. Safety
Precautions
Dextrose 5% in waters should not
used to treat hypovolemic shock.
0.45% saline is not appropriate for
volume expansion
Smaller bolus amounts are
indicated for patients with
suspected or known cardiogenic
shock.
Fresh frozen plasma should be
used only for correction of
coagulopathy and not for volume
replacement.
Oxygen demand should also be
decreased when possible.
24. A 25-year old woman presents to the emergency
department complaining of a cough productive of
tenacious greenish yellow mucus. Vital Signs are
temperature 101.8 F, Heart rate 129/min, respiratory
rate 27/min, and blood pressure 112/68 mm Hg.
25. Vital Signs - heart rate
high, temperature high,
respiratory rate high
Laboratory tests – Blood
work up
Infection around the
body
Low blood oxygen level
Disturbances in the
body's acid-base balance
Poor organ function or
organ failure
Oxyhemoglobin
saturation test
26. Start adequate antibiotic therapy (proper
dosage and spectrum) as early as possible
Fluids given directly into a vein
(intravenously)
Oxygen as needed
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