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Shock & Responses
SWAST EMD Training Pack Refresher Section B: Part 1
| Question | Answer |
|---|---|
| How does the body regulate itself? | The body regulated itself through the release of various hormones to respond to different situations such as being ill or even falling in love! |
| What is the fight or flight response? | The evolutionary response to perceived threats which is when the body will (on a basic level) release hormones to enable the body to: Fight the perceived threat, or Flight (run away) |
| What hormones involved in fight or flight? | adrenaline and cortisol |
| What does adrenaline and cortisol do to the body? | Increase blood pressure Give a boost of energy Preparing the muscles for action |
| Stages of the flight or fight response (4) | An attack, harmful event or threat to survival The brain processes the signals The pituitary gland secretes adrenocorticotropic hormone Cortisol and adrenaline released |
| What parts of the brain process flight or flight? | Amygdala and then the hypothalamus |
| What does the pituitary gland do? | Monitors & regulates many bodily functions through the hormones that it produces, including: Growth and sexual/reproductive development / function. |
| What are the visual physical effects of adrenaline and cortisol? | Loss of bowel control Dilated pupils Dry mouth Vomiting Pale skin |
| What are the internal physical effects of adrenaline and cortisol? | Blood flow to muscles increased Peripheral blood vessel constriction (pale) Blood flow to stomach and intestines is reduced Nausea |
| What is the definition of clinical shock? | Clinical Shock is the state of insufficient blood flow to the tissues of the body as a result of problems with the circulatory system. |
| What are the initial symptoms of clinical shock? | Weakness, fast heart rate, fast breathing, sweating, anxiety and increased thirst. |
| What is the difference between fight or flight and clinical shock? | In clinical shock there is a failure of the body system and despite the body attempting to compensate for the failure (fight or flight) it is unable to do so. |
| Why is it important to identify clinical shock? | The body is unlikely to recover without intervention and the symptoms are likely to progress as the body is unable to provide sufficient blood supply to oxygenate the brain. |
| What can clinical shock lead to? | Agitation, confusion, unconsciousness, and ultimately, cardiac arrest. |
| What can weakness, fast heart rate, fast breathing, sweating, anxiety and increased thirst be a sign of? | Initial clinical shock |
| What does the following refer to? The state of insufficient blood flow to the tissues of the body as a result of problems with the circulatory system. | Clinical Shock (could also be fight or flight) |
| What is not clinical shock? | Surprised or shocked by an event or bad news. |
| How many interventions does the fight or flight response need in comparison to clinical shock? | Minimal interventions |
| What is HYPOVOLAEMIC shock? | Caused by too little fluid in the circulatory system. |
| What causes HYPOVOLAEMIC shock? | Can result from vomiting/diarrhoea, blood loss and burns. |
| What is ANAPHYLACTIC shock? | An overwhelming internal reaction of the body systems. |
| What causes ANAPHYLACTIC shock? | caused by reactions to injections, bites, stings, food and drugs. |
| What is NEUROGENIC shock? | Neurogenic shock is a condition in which you have trouble keeping your heart rate, blood pressure and temperature stable because of damage to your nervous system after a spinal cord injury. |
| What causes NEUROGENIC shock? | caused by inefficient nervous control of blood vessels through disease resulting in bradycardia, hypotension and flushing below the injury site. |
| What is TOXIC shock (SEPSIS)? | SEPSIS is the body's extreme response to infection. A life-threatening medical emergency. Sepsis happens when an infection you have triggers a chain reaction in your body. |
| What causes TOXIC shock (SEPSIS)? | Peritonitis, meningococcal meningitis, viral or fungal infections. |
| Where do SEPSIS infections usually start? | Infections that lead to sepsis most often start in the lung, urinary tract, skin, or gastrointestinal tract. |
| What are the signs & Symptoms of sepsis? | unconsciousness, dizzy or faint breathlessness / fast high temp (fever)/ low body temp confusion or disorientation slurred speech cold, clammy, pale /mottled skin, chills/ shivering increased heartrate muscle pain nausea /vomiting, diarrhoea |
| Primary Response to shock | Increase venous tone via nervous system Mobilising reserve blood volume in peripheral veins Thus decreasing circulatory capacity i.e. small volume + increased pressure |
| Secondary Response to shock | Pulse increases to improve blood flow to vital organs Vasoconstriction of arties supplying non vital organs A loss of greater than 500ml will produce signs and symptoms of shock such as increased respiration and peripheral shutdown. |
| What are the three stages of shock? | Compensated Shock Decompensated Shock Irreversible Shock |
| Compensated Shock signs and symptoms? | Increased pulse Pulse strength decreases skin becomes cool and clammy Progressing anxiety Restlessness agitation thirst Weakness Eventual air hunger |
| Decompensated Shock signs and symptoms? | BP drops Altered level of consciousness progressing to unconsciousness Pulse becomes unpalpable Respirations slow and eventually stopping Central Cyanosis |
| Irreversible Shock signs and symptoms? | Cell and organ damage so significant that recovery is impossible regardless of clinical intervention The end stage of decompensated shock is hard to differ in the field from irreversible shock. |
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paramedicscienceUK
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