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EMS Shock
| Question | Answer |
|---|---|
| What is Shock? | The functional collapse of the cardiovascular system resulting in inadequate delivery of blood to the organs. Shock is very serious and can result in death quickly |
| Cadiogenic Shock | Failure of the pump The heart cannot pump enough blood. Mostly due to a damaged heart Prepare of CPR, O2 |
| Psychogenic Shock | Fancy name of fainting Capillarity response to stress or emotion resulting in a drop of blood pressure Type of Disruptive Shock Least serious. Typically resolves itself, O2 if needed A pipe failure |
| Anaphylactic Shock | Severe allergic reaction causing capillaries to dilate Type of Distributive Shock Can progress very rapidly Treat with epinephrine get to hospital O2 if needed |
| Hemorrhage Shock | Lose of significant amounts of blood. A type of Hypovolemic Shock Not enough blood left for the heart to pump effectively Failure of Fluid Treatment - fix the bleeding, O2, and get to hospital |
| Signs of Shock | Changes in mental status Skin - cold, clammy, pale Rapid, shallow breaths Rapid, weak pulse Thirst - give no fluids BP falling fast |
| General Treatments for Shock | Fix the cause - bleeding, EpiPen O2 - make best use of the blood they have Get to hospital No food or drink - may be in OR soon ABCs Keep warm Position to keep blood in head/lungs Ask about blood thinners - ask while awake! |
| Hypovolemic Shock | Not enough blood volume for heart to be effective Mostly due to blood lose. But can be caused by excessive vomiting, dehydration, or diarrhea |
| Obstructive Shock | Something is blocking blood flow Cardiac Tamponade Tension Pneumothorax Broken ribs Embolism/thrombosis |
| Cardiac Tamponade | pressure on the heard of fluid in the pericardium prevents heart from being a adequate pump Heart is squeezed in its own "wrapper" Type of Obstructive Shock |
| Septic Shock | caused by an overwhelming systemic infection resulting in vasodilation leading to hypotension A type of Distributive Shock |
| Distributive Shock | low blood pressure due to a dilation of blood vessels within the body. Pipe problem Three types: Septic Anaphylactic Neurogenic |
| Types of Shock (5) | Hypovolemic - not enough blood - fluid Cardiogenic - heart muscle failure - pump Obstructive - pressure on the heart - pipes Distributive - dilation of blood vessels - pipes Neurogenic - spinal injury - pipes / pump |
| Treatment for internal bleeding | Not much BLS or ALS can do. High rate O2 Get to the hospital |
| Neurogenic Shock | Spinal cord or brain injury affecting the blood vessels or heart rhythm Type of Distributive Shock |
| Shock | a state of cellular and tissue hypoxia due to either reduced oxygen delivery, increased oxygen consumption, inadequate oxygen utilization, or a combination of these processes |
| Stages of Shock (4) | At Risk Compensated Decompensated - can't compensate any longer Irreversible |
| Compensated Shock (I) | The body attempts to maintain perfusion Heart beats faster, the blood vessels constrict, and the kidney works to retain fluid in the circulatory system Very few symptoms Aggressive treatment may slow or stop progression to stage II |
| Decompensated Shock (II) | When the methods of compensation begin to fail. The systems are unable to maintain perfusion any longer. Oxygen deprivation in the brain causes the patient to become confused and disoriented. |
| Irreversible Shock (III) | The length of time that poor perfusion has existed begins to take a permanent toll on the body's organs and tissues. The heart's functioning continues to spiral downward, and the kidneys usually shut down completely. |
| Hypovolemic shock | decreased blood volume. A type of hypovolemic shock is hemorrhagic shock, which results from blood loss. |
| Obstructive shock | something blocks perfusion to the heart. For example, pulmonary embolism, tension pneumothorax, or cardiac tamponade. |
| Distributive shock | abnormal blood distribution that leads to inadequate blood reaching the heart. vasodilation - increases vaso volume leaking pipes - reduces blood volume anaphalaxis drugs neurogenic infection |
| Neurogenic shock | nervous system injury leading to vasodilation in the periphery causing inadequate perfusion to the vital organs. stroke hemorrhage trauma |
| Anaphylactic shock | severe allergic reaction that leads to vasodilation and bronchoconstriction. |
| Cardiogenic shock | inadequate pumping of the heart. Can be due to heart disease or heart attack. arrhythmia values myopathy pericarditis infarct |
| Shock - early signs (pre compensating) | MA BP (> 10 mmHg from baseline) Heart Rate increasing Cold and Clammy Tachypnea |
| Shock - signs of compensating | Pulse pressure falling PR increasing MA BP falling > 10-15 from baseline Restlessness Apprehensive |
| Shock - signs of decompensating | MA BP falling > 20 mmHg from baseline Hypoxia - very pale Week pulse - rapid AMS |
| Compensating Shock and infants | Infants can compensate better and longer that adults but they crash faster. Be on the look out |
| Treat Shock | Fix the problem (if possible) O2 high flow Keep warm Lay down - sit up if breathing is easier Transport quickly |
| Capillary Permeability | Capillaries can control how much fluid enters and exists the blood. They can open up quickly resulting in a quick drop in BP |
| Compensated Shock | the phase of shock in which the body is still able to compensate for low blood volume Vessel constrictions in extremities. Fast pulse. Fast respiration. Children can compensate longer |
Created by:
danfar
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