hemorrhagic shock

1. Clinical vignette 1
Multiple injury
Hwmo
Maryam AL-Qahtani.
G:3

2. Hemorrhagic shock
is a condition of reduced tissue perfusion,
resulting in the inadequate delivery of oxygen
and nutrients that are necessary for cellular
function.

3. Objectives:
Describe in detail how this patient's body
would compensate for his primary problem.
Is this patient's urinary output normal?

4. How this patient's
body would
compensate for his
primary problem?

5. The body’s response:
Compensated Shock.
Decompensated Shock.
Irreversible Shock.

6. Compensated Shock.
These are the main mechanisms used
to compensate the patient’s condition
:
1- The baroreceptor reflex.
2- Increased sympathetic nervous system
stimulation.
3- Renin-angiotensin-aldosterone (R-A-A) axis.

7. Compensated Shock.
Baroreceptor reflex:
Blood volume
Systemic arterial blood
pressure

9. Increased sympathetic nervous system stimulation helps
to maintain systemic blood pressure in the following
ways:
1/ Increasing the contractility of the heart....>
increasing stroke volume.
2/ Increasing the frequency of action potentials ......>
increasing the heart rate.

10. 3/This increases the resistance ....>
raising blood pressure.
4/contraction of smooth muscle in the
systemic veins.....> increasing the rate
of return of venous blood to the heart(
increases the pre-load and thus stroke
volume of the heart.)

12. Renin-angiotensin-aldosterone
(R-A-A)
axis.

14. Urinary Output
(Normal or abnormal)

15. Case:
Urinary output =20ml per hour.
Normal
value:
Range of 30- 50 ml per hour.

16. In general :
hemorrhagic shock
Reduce blood flow to the kidneys
Making it difficult for the kidneys to cleanse the
bloodstream of waste products and to obtain
enough oxygen and nutrients for its own
metabolic needs.

17. Quiz

18. One of these body response is not one of
compensate for hemorrhagic :
Increase heart rate
Increase blood pressure
Decrease stroke volume

21. Normal value of urinary output
=

23. Compensated Shock:
Early stages of shock where the body’s compensatory
mechanisms are able to maintain normal perfusion .
.Normal range of urinary output 30-50 ml per hour.

24. Guyton & Hall. Text book of Medical physiology .
.Merck Manual.
.Up to data. Website
http://classes.midlandstech.edu/carterp/Courses/bio211/chap19/
chap19.html
http://www.ccmtutorials.com/cvs/shock/page_5.5.htm