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Syok Izma Daud
Syok Izma Daud
Inadequate
Inadequate Anaerobic
Anaerobic Lactic
LacticAcid
Acid
Energy
Energy Metabolism
Metabolism Production
Production
Production
Production
Metabolic
Metabolic Metabolic
Metabolic
Cell
CellDeath!
Death!
Failure
Failure Acidosis
Acidosis
Compensatory Mechanisms
Sympathetic Nervous System (SNS)-
Adrenal Response
SNS - Neurohormonal response
Stimulated by baroreceptors
•Increased heart rate
•Increased contractility
•Vasoconstriction (SVR-Afterload)
•Increased Preload
Renin-Angiotensin-Aldosterone
Plasma
Plasma Kidney
Kidney
volume
volume
Detected by (juxtaglomerular
(juxtaglomerular
&/Or apparatus)
apparatus)
[Na+]
[Na+] Releases
Via ACE
(Angiotensin
Converting Renin
Renin
Enzyme)
Converts
Angiotensin
AngiotensinII…
II…
Angiotensin I… Angiotensinogen
AngiotensinI…
Renin-Angiotensin-Aldosterone
vasoconstriction
vasoconstriction PVR
PVR
Angiotensin
AngiotensinII…
II…
thirst
thirst
ADH
ADH
(anti-diuretic Fluid
Fluid
(anti-diuretic BP!
BP!
hormone) volume
volume
hormone)
Adrenal
Adrenal
Releases Na+
Na+
cortex Aldosterone
Aldosterone reabsorption
cortex reabsorption
KLASIFIKASI SYOK
SYOK
HIPOVOLEMIK
SYOK SYOK
OBSTRUKTIF SYOK DISTRIBUTIF KARDIOGENIK
•Syok Neurogenik
•Syok Anafilaktik
•Syok Septik
Classification of Shock
• COMPENSATED
– blood flow is normal or increased and may be
maldistributed; vital organ function is maintained
• UNCOMPENSATED
– microvascular perfusion is compromised; significant
reductions in effective circulating volume
• IRREVERSIBLE
– inadequate perfusion of vital organs; irreparable
damage; death cannot be prevented
Other Classification
• Hypovolemic Shock
• Non-hemorrhagic Shock
– Cardiogenic Shock
– Septic Shock
– Neurogenic Shock
– Anaphylactic Shock/Vasogenic Shock
early
late
Treatment for Hypovolemic Shock
• Position casualty
• Keep patient at normal temperature
– Prevent hypothermia
– Minimize effect of shock
• Fluid therapy
• Drug therapy
• On-going assessment - every 10-15 minutes
36
Treatment for Septic Shock
• Secure airway
• Administer oxygen
• Baseline vital signs
• Level of consciousness
• Position casualty
• Keep patient at normal temperature
Sumber : McSwain & Frame ( 2003 ). PHTLS, Basic and advanced prehospital
Trauma life support.5th Ed USA : Mosby
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