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  • Definisi Shock, Klasifikasi Shock, dan Stadium Shock

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    This document defines and classifies shock. It discusses four stages of shock: compensated, uncompensated, irreversible, and four classes of hemorrhagic shock based on estimated blood and fluid loss. Compensated shock occurs when the body attempts to preserve organs through mechanisms like vasoconstriction, but signs are subtle. Uncompensated shock occurs when mechanisms fail and signs are more apparent, like prolonged capillary refill. Irreversible shock occurs when compensatory mechanisms completely fail and cell death begins in vital organs. The four classes of hemorrhagic shock are classified based on estimated blood loss percentage and accompanying vital signs and mental status.

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    Definisi Shock, Klasifikasi Shock, Stadium Shock

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    This document defines and classifies shock. It discusses four stages of shock: compensated, uncompensated, irreversible, and four classes of hemorrhagic shock based on estimated blood and fluid loss. Compensated shock occurs when the body attempts to preserve organs through mechanisms like vasoconstriction, but signs are subtle. Uncompensated shock occurs when mechanisms fail and signs are more apparent, like prolonged capillary refill. Irreversible shock occurs when compensatory mechanisms completely fail and cell death begins in vital organs. The four classes of hemorrhagic shock are classified based on estimated blood loss percentage and accompanying vital signs and mental status.

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    316 views8 pages

    Definisi Shock, Klasifikasi Shock, dan Stadium Shock

    Uploaded by

    sekiann
    This document defines and classifies shock. It discusses four stages of shock: compensated, uncompensated, irreversible, and four classes of hemorrhagic shock based on estimated blood and fluid loss. Compensated shock occurs when the body attempts to preserve organs through mechanisms like vasoconstriction, but signs are subtle. Uncompensated shock occurs when mechanisms fail and signs are more apparent, like prolonged capillary refill. Irreversible shock occurs when compensatory mechanisms completely fail and cell death begins in vital organs. The four classes of hemorrhagic shock are classified based on estimated blood loss percentage and accompanying vital signs and mental status.

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    Definisi Shock, Klasifikasi Shock, Stadium Shock, Klasifikasi Perdarahan

    Oleh

    Herman Tuah Sitohang 080100106

    Definition of Shock
    Reduced perfusion of vital organs leading to inadequate oxygen and nutrients necessary for normal tissue and cellular function. DO2 < VO2
    Cellular level:

    Reduction of mitochondrial oxygen Anaerobic glycolysis of ATP Accumulation of pyruvate lactate Lactic Acidosis

    Klasifikasi Shock
    1. Hemorrhagic Shock 2. Non Hemorrhagic Shock
    Cardiogenic Tension pneumothorax Neurogenic Septic Anaphylactic

    STAGES OF SHOCK

    COMPENSATED SHOCK
    Body defense mechanisms attempt to preserve major organs Precapillary sphincters close, blood is shunted Increased heart rate and strength of contractions Increased respiratory function, bronchodilation Will continue until problem solved or shock progresses to next stage Can be difficult to detect with subtle indicators Tachycardia Decreased skin perfusion Alterations in mental status Some medications such as propranolol can hide signs and symptoms 5

    UNCOMPENSATED SHOCK
    Physiological response Precapillary sphincters open, blood pressure falls Cardiac output falls Blood surges into tissue beds, blood flow stagnates Red cells stack up in rouleaux Easier to detect than compensated shock Prolonged capillary refill time Marked increase in heart rate Rapid thready pulse Agitation, restlessness, confusion
    6

    IRREVERSIBLE SHOCK
    Compensatory mechanisms fail, cell death begins, vital organs falter Patient may be resusitated but will die later of (ARDS, renal and liver failure, sepsis)

    Estimated Fluid and Blood Losses Based on Patients Initial Presentation


    Class I
    Blood-Loss[ml] Blood-loss [%BV] Pulse-Rate [x/min.] Blood-Pressure Pulse-Pressure Respiratory Rate Urine out-put [ml/hour] Mental status/CNS ->750 ->15% <100 Normal N or increased 14-20 >30 Slightly anxious

    Class II
    750-1500 15-30% >100 Normal Decreased 20-30 20-30 Midly anxious

    Class III Class IV


    1500-2000 30-40% >120 Decreased Decreased 30-35 5-15 Anxious and confused >2000 >40% >140 Decreased Decreased >35 Negligible Confused and lethargic

    EBV = 70 ml/kg
    13/12/2013 8

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