Management of shock and

circulation

Dr H Atik Sutisna, SpAn

 SHOCK
GANGGUAN PERFUSI JARINGAN YG MENYEBABKAN
INSUFISIENSI KADAR OKSIGEN DAN NUTRIEN SEHINGGA
TERJADI KEGAGALAN METABOLISME SELULER

GANGGUAN PERFUSI JARINGAN

(proses masuknya darah ke dalam jaringan/ sel)

penurunan kadar oksigen dalam

darah arteriel

Gangguan sirkulasi
 SHOCK

The ESSENTIAL signs of shock :

tachycardia/tachypnoe (compensatory
mechanisms),
hypotension
poor end-organ perfusion (such as low urine
output)
confusion or loss of consciousness
Hinshaw and Cox classification
of shock

Hypovolemic shock
Cardiogenic shock
Distributive shock : insufficient intravascular
volume of blood.
Septic shock
Anaphylactic shock :
Caused by a severe anaphylactic reaction to an allergen,
antigen, drug or foreign protein causing the release of
histamine which causes widespread vasodilation, leading to
hypotension and increased capillary permeability.
Hinshaw and Cox classification
of shock

Neurogenic shock : rarest cases

caused by trauma to the spinal cord resulting in
the sudden loss of autonomic and motor reflexes
below the injury level
Obstructive shock :
Cardiac tamponade
Tension pneumothorax
Massive pulmonary embolism
Aortic stenosis
Hinshaw and Cox classification
of shock

Endocrine shock : based on endocrine

disturbance
Hypothyroidism
Thyrotoxicosis (Cardiogenic shock )

Acute adrenal insufficiency (Distributive shock)

Shock :......... Pathophysiology
Basic principal management

Shock requires immediate interventions to preserve

life....... .RESUSCITATION ( CPCR )

venous line (s) :

USE VENOCATH PERFECTLY
BEGIN FROM DISTAL VEIN OF
HANDS OR LEGS

VENA SECTIE
Basic principal management

CHOICE OF FLUIDS REPLACEMENT

CRISTALOID
> Dextrose 5 %/ 10 %
> Normal Saline : NaCl 0,9 %
> Ringer lactate/acetate MIXED

COLOID

DO NOT USED DEXTROSE ON SHOCK

Basic principal management

DRUGS :

SULFAS ATROPIN
CORTICOSTEROID
VASSOPRESSOR :
> alpha : ephinephrine
> beta : dopamine/dobutamine
Basic principal management

MIXED OF FLUIDS AND DRUGS

2 VENOUS LINES

1st step :
1. COLOID
2. CRISTALOID (+) drugs ( vassopressor )

2nd step :
1. Cristaloid/blood/Nutrient fluids
2. Cristaloid
Be a professional medical doctors, ................ thankyou