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 ◦ ◦ ◦ ◦ ◦ BRADY 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