Page 582 - ACCCN's Critical Care Nursing

Management of Shock 559

Learning activities, Continued
1. What assessments are important to obtain appropriate infor- Reflect on a case of a patient with shock that you have been
mation for a patient presenting with signs of hypoperfusion? involved in, and consider the following:
2. What systems are in place where you work to ensure adequate 5. What elements of care or ‘care bundles’ were effective in man-
processes are in place to assess patients presenting in shock? aging symptoms of shock?
3. How could the patient in the case study have been managed 6. What processes would you use in future to syste-
differently? matically assess, manage and evaluate care of a patient in
4. What are the clinical escalation processes in the facilities you shock?
have worked in?

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FURTHER READING 22. Nguyen HB, Rivers EP, Knoblich BP, et al. Early lactate clearance is associated
with improved outcome in severe sepsis and septic shock. Crit Care Med
Manji RA, Wood KE, Kumar A. The history and evolution of circulatory shock. 2004; 32(8): 1637–42.
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Australian Commission on Safety and Quality in Healthcare. Recognising and 2003; 31(8Suppl): S502–11.
responding to clinical deterioration: Background Paper, June 2008. Available from: 24. Sherwood ER, Toliver-Kinsky T. Mechanisms of the inflammatory response.
http://www.safetyandquality.gov.au/internet/safety/publishing.nsf/Content/ Best Pract Res Clin Anaesth 2004; 18(3): 385–405.
AB9325A491E10CF1CA257483000C9AC4/$File/BackgroundPaper-2009.pdf
25. Leach R, Treacher D. Oxygen transport-2. Tissue hypoxia. BMJ 1998;
317(7169):1370–73.
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