Transcript Shock
Chapter 10
Shock
BRADY
National Ski Patrol, Outdoor Emergency Care, 5th
©2012 by Pearson Education, Inc., Upper Saddle River, NJ
Anatomy and Physiology
Heart
◦ Four chambers
Blood
vessels
◦ Arteries – away from the
heart
◦ Veins – toward the heart
Blood
BRADY
How the Heart Pumps Blood
National Ski Patrol, Outdoor Emergency Care, 5th
©2012 by Pearson Education, Inc., Upper Saddle River, NJ
What is Shock?
Failure of the circulatory system to
maintain adequate blood flow to tissues
Leads to inadequate tissue perfusion in
which cells do not receive sufficient O2
& nutrients
continued
BRADY
National Ski Patrol, Outdoor Emergency Care, 5th
©2012 by Pearson Education, Inc., Upper Saddle River, NJ
Stages of Shock
Compensated
shock
Decompensated shock
Irreversible shock
Important
terms:
◦ Tachypnea & tachycardia
continued
BRADY
National Ski Patrol, Outdoor Emergency Care, 5th
©2012 by Pearson Education, Inc., Upper Saddle River, NJ
Types of Shock
Hypovolemic
◦ Results from a critical decrease in
circulating blood volume
Caused
by a loss of circulating blood
or internal body water
BRADY
National Ski Patrol, Outdoor Emergency Care, 5th
©2012 by Pearson Education, Inc., Upper Saddle River, NJ
Types of Shock
Cardiogenic
◦ Heart cannot adequately pump blood
The
defect occurs within the heart
itself
Examples?
continued
BRADY
National Ski Patrol, Outdoor Emergency Care, 5th
©2012 by Pearson Education, Inc., Upper Saddle River, NJ
Types of Shock
Distributive
◦ Blood vessels lose their ability to
constrict appropriately
3
subtypes: septic, anaphylactic,
neurogenic
BRADY
National Ski Patrol, Outdoor Emergency Care, 5th
©2012 by Pearson Education, Inc., Upper Saddle River, NJ
Types of Shock
Septic
◦ Caused by an infection known as sepsis
Anaphylactic
◦ Severe allergic reaction
Neurogenic
◦ Caused by disruptions of the CNS
BRADY
National Ski Patrol, Outdoor Emergency Care, 5th
©2012 by Pearson Education, Inc., Upper Saddle River, NJ
Types of Shock
Obstructive
shock
◦ Tension pneumothorax
◦ Pericardial tamponade
◦ Pulmonary embolism
BRADY
National Ski Patrol, Outdoor Emergency Care, 5th
©2012 by Pearson Education, Inc., Upper Saddle River, NJ
Factors Affecting Shock
Age
Concurrent
illness or injury
Pre-existing medical condition
Mind-altering substances or
medications
Prescription or over-the-counter
(OTC) medications
BRADY
National Ski Patrol, Outdoor Emergency Care, 5th
©2012 by Pearson Education, Inc., Upper Saddle River, NJ
Patient Assessment
MOI
◦ Scene size up
◦ Clues; suggestion possible shock
Classic
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◦
◦
◦
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signs
Tachycardia
Hypotension
Tachypnea
Pale, cool, diaphoretic skin
Altered mental status
National Ski Patrol, Outdoor Emergency Care, 5th
©2012 by Pearson Education, Inc., Upper Saddle River, NJ
Patient Management
High
flow oxygen
Return to homeostasis
Place in shock position
Transport in head down position
BRADY
National Ski Patrol, Outdoor Emergency Care, 5th
©2012 by Pearson Education, Inc., Upper Saddle River, NJ
Skill 10-1
Shock Management
BRADY
National Ski Patrol, Outdoor Emergency Care, 5th Ed.
©2012 by Pearson Education, Inc., Upper Saddle River,
NJ
OEC Skill 10-1 Shock Management (a) Assess scene safety and initiate
Standard Precautions. Copyright Scott Smith
BRADY
National Ski Patrol, Outdoor Emergency Care, 5th
©2012 by Pearson Education, Inc., Upper Saddle River, NJ
OEC Skill 10-1 Shock Management (b) Perform a primary assessment.
Assess ABCDs and correct any problems found. Copyright Scott Smith
BRADY
National Ski Patrol, Outdoor Emergency Care, 5th
©2012 by Pearson Education, Inc., Upper Saddle River, NJ
OEC Skill 10-1 Shock Management (c) Call for help and arrange for transport
that includes ALS. Copyright Scott Smith
BRADY
National Ski Patrol, Outdoor Emergency Care, 5th
©2012 by Pearson Education, Inc., Upper Saddle River, NJ
OEC Skill 10-1 Shock Management (d) Monitor the airway and administer
high-flow oxygen. Copyright Scott Smith
BRADY
National Ski Patrol, Outdoor Emergency Care, 5th
©2012 by Pearson Education, Inc., Upper Saddle River, NJ
OEC Skill 10-1 Shock Management (e) To prevent heat loss, keep the patient
warm and dry. Copyright Scott Smith
BRADY
National Ski Patrol, Outdoor Emergency Care, 5th
©2012 by Pearson Education, Inc., Upper Saddle River, NJ
OEC Skill 10-1 Shock Management (f) Place the patient with the head lower
than the feet while maintaining spinal integrity. Copyright Scott Smith
BRADY
National Ski Patrol, Outdoor Emergency Care, 5th
©2012 by Pearson Education, Inc., Upper Saddle River, NJ
OEC Skill 10-1 Shock Management (g) Provide for rapid transport.
Copyright Selko
BRADY
National Ski Patrol, Outdoor Emergency Care, 5th
©2012 by Pearson Education, Inc., Upper Saddle River, NJ
Early recognition!!
Early
recognition of the potential for
shock is essential in reducing the
number of deaths from this condition.
continued
BRADY
National Ski Patrol, Outdoor Emergency Care, 5th
©2012 by Pearson Education, Inc., Upper Saddle River, NJ