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Obstructive Shock Final Edit

1) Obstructive shock can be caused by massive pulmonary embolism, aortic dissection, cardiac tamponade, or tension pneumothorax. 2) Massive pulmonary embolism is usually caused by deep vein thrombosis and can be investigated with D-dimer, CTPA, and ultrasound of the legs. Treatment involves anticoagulants, thrombolytics, or embolectomy. 3) Cardiac tamponade causes acute heart failure due to compression of the heart chambers and is commonly seen in disseminating aortic aneurysms or pericarditis. Diagnosis is mainly clinical and treatment involves pericardiocentesis or pericardiectomy.

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Mohamed Suhail
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157 views12 pages

Obstructive Shock Final Edit

1) Obstructive shock can be caused by massive pulmonary embolism, aortic dissection, cardiac tamponade, or tension pneumothorax. 2) Massive pulmonary embolism is usually caused by deep vein thrombosis and can be investigated with D-dimer, CTPA, and ultrasound of the legs. Treatment involves anticoagulants, thrombolytics, or embolectomy. 3) Cardiac tamponade causes acute heart failure due to compression of the heart chambers and is commonly seen in disseminating aortic aneurysms or pericarditis. Diagnosis is mainly clinical and treatment involves pericardiocentesis or pericardiectomy.

Uploaded by

Mohamed Suhail
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PPTX, PDF, TXT or read online on Scribd
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OBSTRUCT I V E S HO C K

CAUSES OF OBSTRUCTIVE SHOCK


• MASSIVE PULMONARY EMBOLISM OR PULMONARY EDEMA
• AORTIC DISSECTION
• CARDIAC TAMPONADE /CONSTRICTIVE PERICARDITIS/ RESTRICTIVE
CARDIOMYOPATHY

• TENSION PNEUMOTHORAX
• OBSTRUCTION OF VENOUS RETURN TO HEART
• SOURCE: 1) DVT 2) FAT 3) AIR 4) AMNIOTIC FLUID 5) SEPTIC EMBOLI
MASSIVE • INVESTIGATIONS: 1)D-DIMER 2) CXR 3) CTPA 4) V/ Q SCAN 5) USG OF LEG 6) ECHO
PULMONARY• TREATMENT :ANTICOAGULANT, THROMBOLYTICS, IVC FILTER, EMBOLECTOMY,
EMBOLISM PERCUTANEOUS THROMBECTOMY

• PREVENTION: COMPRESSION STOCKINGS, PNEUMATIC COMPRESSION DEVICE, EARLY


MOBILIZATION AFTER SURGERY
HAMPTONS HUMP
CARDIAC TAMPONADE
ACUTE HEART FAILURE DUE TO COMPRESSION
OF THE HEART CHAMBER BY A LARGE OR
RAPIDLY DEVELOPING EFFSUION (EXUDATE/
TRANSUDATE OR BLOOD AND LEADING TO A
DECREASE IN CARDIAC OUTPUT AND SHOCK.

• CAUSES:DISSECTING AORTIC ANEURYSM


(THORACIC), END-STAGE LUNG CANCER,
(ACUTE MI), HEART SURGERY,
PERICARDITIS, BLUNT TRAUMA.

• SYMPTOMS: TACHYCARDIA, , DROWSINESS,


SHARP PAIN IN THE CHEST, BACK, ABDOMEN,
OR SHOULDER

• DIAGNOSIS: MAINLY CLINICALLY ASSESSED

• INVESTIGATIONS:ECHO, CXR-WATER
BOTTLE SIGN, CT ,ECG, HEART
CATHETERIZATION

• TREATMENT:PERICARDIOCENTESIS,
SURGICAL PERICARDIECTOMY
Echo in cardiac
tamponade
TENSION PNEUMOTHORAX
LIFE-THREATENING CONDITION CAUSED BY THE CONTINUOUS
ENTRANCE AND ENTRAPMENT OF AIR INTO THE 
PLEURAL SPACE, THEREBY COMPRESSING THE LUNGS, HEART,
BLOOD VESSELS, AND OTHER STRUCTURES IN THE CHEST

• CAUSES:STAB WOUND OR A GUNSHOT; OR A CLOSED


TRAUMA, LIKE A RIB FRACTURE, MECHANICAL
VENTILATED PATIENT.

• SYMPTOMS:SEVERE SHORTNESS OF BREATH, SHALLOW


BREATHING, ACUTE CHEST PAIN, HYPOXIA,
TACHYCARDIA, HYPOTENSION AND ALTERED MENTAL
STATUS

• INVESTIGATIONS:CXR, CT CHEST, USG CHEST

• TREATMENT:NEEDLE THORACOSTOMY, CHEST TUBE


INSERTION
NEEDLE THORACOSTOMY AND CHEST TUBE INSERTION
TRIANGLE OF SAFETY
NEEDLE
DECOMPRESSION
14 OR 16 G NEEDLE
INSERTED IN 2ND
OR 3RD
MIDCLAVICULAR
LINE

CHEST TUBE
4 TH INTERCOSTAL
SPACE ANTERIOR
AXILLARY LINE
(SKIN INCISION 1
ICS BELOW
AORTIC DISSECTION
AORTIC DISSECTION STANFORD TYPE A AND TYPE B
AORTIC DISSECTION MANAGEMENT

• INVESTIGATIONS: CXR, TEE, CT CHEST, MRA,ECHO


• IMMEDIATE SURGERY IS NEEDED FOR TYPE A AORTIC DISSECTION
• TYPE B AORTIC DISSECTION REQUIRES EMERGENCY SURGERY IF THE DISSECTION
CUTS OFF BLOOD FLOW TO YOUR VITAL ORGANS.

• LESS SEVERE CASES MAY BE TREATED WITH MEDICATION-BETABLOCKERS


• GRAFT REPLACEMENT (SURGICAL)
• ENDOVASCULAR STENT-GRAFT REPAIR (SURGICAL)
SUMMARY

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