Welcome to the lesson on responding to distributive shock. In this video, we'll discuss responding to septic and lactic and neurogenic shock. The initial management of distributed shock is to increase intravascular volume. The intent is to provide enough volume to overcome the inappropriate redistribution of existing volume. To do so, administer 20 milliliters per kilogram of fluid as a bolus over five to 10 minutes. Repeat as needed.
Beyond initial management therapy is tailored to the cause of the distributed shock. In septic shock, aggressive fluid management is generally necessary. broad spectrum intravenous antibiotics are a key intervention should be administered as soon as possible. In addition, a stressed dose of hydrocortisone, especially with adrenal insufficiency, and vessel pressors may be needed to support blood pressure. After fluid resuscitation, faster presser should given if needed, and according to the type of septic shock Normal tense of individuals are usually given dopa MI, warm shock is treated with norepinephrine and cold shock is treated with epinephrine. transfusing packed red blood cells to bring hemoglobin above 10 grams per deciliter, treats decreased oxygen carrying capacity.
As blood cultures return, focus antibiotic therapy to the particular microbe and its resistance patterns for anaphylaxis shock intramuscular. epinephrine is the first and most important treatment. In severe cases, a second dose of epinephrine may be needed, or intravenous administration may be required. crystalloid fluid can be administered judiciously. Remember that an NF lactic shock, capillary permeability may increase considerably. Thus, while it's important to support blood pressure overall, there's significant likelihood that third spacing and pulmonary edema will occur.
Anti histamines and corticosteroids can also blunt the anaplastic response if breathing changes As arise, consider albuterol use to achieve bronchodilation. In very severe cases of anaphylaxis shock, a continuous epinephrine infusion in the neonatal intensive care unit or an ICU or pediatric intensive care unit or P ICU may be required. neurogenic shock is clinically challenging, because often there is limited ability to correct the insult. injury to the autonomic pathways in the spinal cord results in decreased systemic vascular resistance and hypotension. And inappropriately low pulse or Braddock cardia is a clinical side of neurogenic shock. Therefore, treatment is focused on fluids first, administer 20 milliliters per kilogram bolus over five to 10 minutes, then reassess the individual for a response.
If hypotension does not respond to fluid resuscitation faster pressors are needed. This resuscitation should be done in conjunction with a broader neurological evaluation and treatment plan. This concludes our lesson on responding to distributive shock. Next, we'll review responding to cardiogenic shock