Hypovolemic Shock: Introduction (Nursing)

00:01 Hi, I'm Professor Lawes. And in this video series, we're going to talk about Hypovolemic Shock.

00:07 Now the name tells you everything.

00:10 Hypo means low. Volemic means volume.

00:14 And shock, no matter what the word is in front of it always means not enough to meet the body's metabolic needs.

00:22 Now, there's main types of shock.

00:24 And that could include cardiogenic shock.

00:26 That's caused by some heart problems.

00:29 Hypovolemic shock, which is what we're talking about.

00:32 That's because there's not enough blood volume.

00:34 Anaphylactic shock, which is caused by an allergic reaction.

00:38 Septic shock due to a massive infection, or neurogenic shock, which is caused by damage to the nervous system.

00:45 Now, why do you care? Well, it matters because shocking all these is that we don't have enough blood circulating around not getting enough oxygen to the tissues to meet the body's metabolic needs.

00:59 The word before shock is what caused it cardiogenic - heart, hypovolemic - not enough volume.

01:05 Anaphylaxis, wow, you've got some massive allergic reaction.

01:09 Airways tightening up.

01:10 So you're not able to deliver oxygen to the tissues.

01:14 The reason it matters to you is because we treat each one of these differently.

01:19 In this video series, we're going to focus on hypovolemic shock.

01:23 That's the cause of not enough oxygen being delivered to the tissues.

01:29 So here we have a human body.

01:32 You see, normally the body is completely full of volume, right.

01:35 You have an appropriate amount of blood in your body, able to circulate oxygen, pick up CO2, get rid of it, everything is functioning normally.

01:45 But someone in hypovolemic shock has too low of volume available in the intravascular space.

01:53 Now, that part is really important. Okay.

01:55 We're showing you here, the intravascular space.

01:58 That's your veins and arteries, all connected to your cardiovascular system.

02:03 Sometimes patients can have fluid in their bodies, but not in their intravascular space.

02:09 So keep that in mind.

02:10 Hypovolemic shock means not enough volume in your intravascular space to maintain adequate perfusion of your organs.

02:19 So end up with this organ dysfunction that happens because tissue hypoxia is occurring,.

02:25 Not enough fluid to deliver oxygen to the tissues, because there's decreased oxygen delivery because of too low of volume in the intravascular space.

02:36 Now, how does this happen? How do I end up with not enough volume in my intravascular space? Well, significant bleeding.

02:43 Now we show someone with an arm bleeding there, but you could have internal bleeding also.

02:48 So hemorrhagic shock means blood is exiting the vascular system, It might be exiting externally, or it could be exiting internally.

02:58 The point is, it's not in the intravascular space.

03:02 Burns is kind of an unusual one is a horrific injury.

03:06 But in burns, there is massive fluid shifting.

03:10 So we call that relative hypovolemia.

03:13 That means there's fluid in the body, but it's not in the intravascular space.

03:18 It moves into the extravascular space.

03:21 And fluid that is not in the intravascular space will cause a drop in blood pressure.

03:27 So even though you have enough fluid, technically in the body with the burn, a serious burn, you'd have relative hypovolemia, because you have the massive fluid shifting.

03:37 They can have really significant GI losses.

03:40 If a patient has just vomiting and vomiting and vomiting, they might have extreme diarrhea, they're ending up losing a lot of extra fluid, which ends up resulting in less fluid in your intravascular space.

03:54 Same thing can happen if somebody has polyuria.

03:57 Poly means many. Urea is urinating.

04:01 So somebody has something going on and they're putting out excessive amounts of urine can also lead to hypovolemic shock.