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EMS Chapter10 Review

Emergency Care & Transp. 10th Edition 2011 Jones & Bartlett

• Perfusion requires an intact cardiovascular system and a functioning respiratory system.
• Remember, most types of shock (hypoperfusion) are caused by dysfunction in one or more parts of the perfusion triangle: – The pump (the heart) – The pipes, or container (blood vessels) – The content, or volume (blood)
• Shock (hypoperfusion) is is the collapse and failure of the cardiovascular system, when blood circulation slows and eventually stops.
• Blood is the vehicle for carrying oxygen and nutrients through the vessels to the capillary beds to tissue cells, where these supplies are exchanged for waste products.
• Blood contains red blood cells, white blood cells, platelets, and a liquid called plasma.
• The systolic pressure is the peak arterial pressure, or pressure generated every time the heart contracts; the diastolic pressure is the pressure maintained within the arteries while the heart rests between heartbeats.
• The various types of shock are cardiogenic, obstructive, septic, neurogenic, anaphylactic, psychogenic, and hypovolemic.
• Signs of compensated shock include anxiety or agitation; tachycardia; pale, cool, moist skin; increased respiratory rate; nausea and vomiting; and increased thirst. If there is any question on your part, treat for shock. It is never wrong to treat for shock.
• Signs of decompensated shock include labored or irregular respirations, ashen gray or cyanotic skin color, weak or absent distal pulses, dilated pupils, and profound hypotension.
• Remember, by the time a drop in blood pressure is detected, shock is usually in an advanced stage.
• Anticipate shock in patients who may have the following conditions: – Severe infection – Significant blunt force trauma or penetrating trauma – Massive external bleeding or index of suspicion for major internal bleeding – Spinal injury – Chest or abdominal injury – Major heart attack – Anaphylaxis
• Treating a pediatric or geriatric patient in shock is no different than treating any other shock patient.
• Treat all patients suspected to be in shock from any cause as follows and in this order: – Open and maintain the airway. – Provide high-flow oxygen and as needed, provide bag-mask assisted ventilations. – Control all obvious external bleeding.
• Treat all patients also suspected to be in shock from any cause as follows and in this order:2 – Place the patient in the shock position or, if on a backboard or stretcher, in the Trendelenburg’s position. – Maintain normal body temperature with blankets. – Provide prompt transport to the appropriate hospital.
Created by: Liwa91