[Surgicalcric]

CARDIOGENIC: When the heart fails to pump enough blood.
Causes: MI when 40-50% of the myocardium is destroyed, or secondary to valve dysfunction or cardiomyopathies or cardiac arrest
S/S: Increased workload on ventricles from catecholamine release; Restlessness; weakness; alterations in mentation; Decreased urine output (oligouria); Alterations of peripheral perfusion; pallor; cyanosis; Tachycardia; hypotension; dysrhythmias; Deteriorated pulmonary status (congestion and/or edema) and eventually Cardiac arrest
TX: CPR and follow ACLS protocols, Vasopressors and diuretics, Intra-aortic balloon device or ventricular assist devices, Heart transplant

HYPOVOLEMIC: When volume of bloods loss is enough to inhibit tissue perfusion.
Causes: Hemorrhage, Vomiting and diarrhea, Burns, third space fluid loss.
S/S:
Mild: Volume loss is 10%;CO is decreased and SNS is activated; Skin is pale, cool and clammy; Mucosa is mildly dry; Skin turgor is decreased; Anxiety, restlessness, thirst, weakness
Moderate: Volume loss is 15-40%; CO and BP decrease dramatically; Tachycardia; tachypnea; pallor; Poor skin turgor; Thirst; restlessness; weakness; Decreased urine output
Severe: Volume loss exceeds 45%; Vital organ functions display effects of decreased perfusion; Decreased level of consciousness; confusion; agitation; Metabolic acidosis; and eventually death
TX: treat cause of loss and replace fluid loss 3:1 with an isotonic solution and packed RBC

DISTRIBUTIVE: When there is a loss is SVR.
Causes: Sepsis(TSS, SIRS), Neurological trauma, or Anaphylaxis from food, drugs, or insect stings
S/S:
Sepsis: Hypotension, Fever, Decreased CO, tachycardia, dysrhythmias, Clammy, pale skin, Pulmonary congestion, tachypnea
Anaphylaxis: Alterations in mentation; Urticaria; pruritus; Bronchoconstriction; tachypnea; wheezing; Warm and flushed skin;Tachycardia; angina; dysrhythmias; hypotension; Decreased CO
Neurologic: Alterations in LOC; Cool and clammy skin above lesion; Warm and dry below lesion; Bradycardia; Hypotension; Tachypnea
TX: IV fluids to fill container, Probably give vasopressors
Sepsis: ID and eliminate nidus of infection, ABX therapy
Anaphylaxis: benadryl 50mg IV, 1mg 1:10,000EPI IV(if patient is mearly having an allegic reaction .03mg 1:1000 EPI SQ)
Neurological: fix spinal dysfunction, steroids, vasopressors

OBSTRUCTIVE: When something permits the heart from pumping.
Causes: Cardiac Tamponade, Pneumothorax, or PE
S/S: b/p drop as tamponade becomes greater, pulse pressures narrow, Tachycardic, tachypnic, skin cool/clammy, LOC drops as CO decreases.
TX:
Cardiac Tamponade: Pericardialcentesis
Pneumothorax: Needle/tube Thorocotomy
PE: Systemic anticoagulation, possibly thrombolysis or surgical embolectomy.