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Anaphylactic shock | Anaphylactic shock | ||
− | + | Hypovolemia caused by allergic reaction (peripheral vasodilatation and increased vascular permeability) with varying degrees of severity: | |
Grad 1: Urtikaria, Flush | Grad 1: Urtikaria, Flush |
Def: Shock is an acute haemodynamic disorder with insufficient oxygen supply to tissues and organs in relation to demand.
Cardiogenic shock:
Reduction of cardiac output by decreasing the cardiac output of the heart
(mostly in the context of a heart attack, rhythm disturbances or pulmonary embolism)
Symptoms:
General shock signs such as paleness, acrocyanosis, cold sweat, dyspnea, restlessness, anxiety, clouding of consciousness, optional pulmonary edema, influence congestion, RR < 90 mmHg, tachycardia
In cases of cardiogenic shock as a result of myocardial infarction, PTCA is the primary target. This brings better therapeutic results than lysis. Catecholamines (adrenalin, dopamine, dobutamine, arterenol) are available via perfusor to stabilize the patient.
Traumatic Shock
Combination of hypovolemia (bleeding) and soft tissue injury (pain, mediator release)
The extent of a traumatic shock can be estimated from:
Anamnesis (accident history - impact of forces)
Injury pattern (varying blood loss depending on localization of fractures)
Clinical signs: anxiety, restlessness, confusion, acrocyanosis, sweating, dyspnea, tachypnea
Blood pressure and pulse
Anaphylactic shock
Hypovolemia caused by allergic reaction (peripheral vasodilatation and increased vascular permeability) with varying degrees of severity:
Grad 1: Urtikaria, Flush
Grad 2: Urtikaria, Flush, Übelkeit, Erbrechen, Tachykardie, leichte Hypotension
Grad 3: Urtikaria, Flush, Übelkeit, Erbrechen, Durchfall, Tachykardie, Schocksymptomatik, Bronchospasmus, ev. Quincke-Ödem
Grad 4: Herz-Kreislauf-Stillstand
Septischer Schock
Bei Infektion mit Bakterien, Bakteriämie und Endotoxinämie
Symptome sind Fieber, Schüttelfrost, warme Peripherie, Blutdruck <90 mmHg, Tachykardie, Dyspnoe, Tachypnoe bis zur respiratorischen Insuffizienz.
Neurogener Schock
Bei Läsionen der HWS oder BWS mit Rückenmarksverletzung ist einerseits die Atmung beeinträchtigt (je nach Höhe der Läsion Ausfall der Interkostalmuskulatur bis zur Phrenikusparese) und andrerseits kommt es durch Ausfall der sympathischen Nervenfasern zu einer funktionellen Sympathektomie mit Bradykardie und Hypotension.