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12. OBJ

Shock & Resuscitation

TermDefinition
12-O1. Pathophysiology of shock (hypoperfusion) Hypoperfusion/collapse & failure of the cardiovascular system Perfusion: Circulation of blood in organ/tissue to meet cells needs for oxygen, nutrients & waste removal
12-O2. Causes of shock Pump failure Poor vessel function Low fluid volume Bleeding Respiratory failure Acute allergenic reactions Infection
12-O3. A. Types of shock - Cardiogenic: Inadequate function of heart or pump function - Obstructive: Mechanical obstruction which prevents adequate volume of blood to fill the heart chambers - Distributive: Wide spread dilation of small arterioles, venules, both
12-O3.B. Types of shock - Septic:Sever infections(bacterial)-muscular tone/blood vessels - Neurogenic:High spinal cord inj. - Anaphylactic:Severe reaction to sensitized substance - Psychogenic:Sudden reaction of nervous system- temporary vascular dilation, syncope
12-O3.C. Types of shock - Hypovolemic: Inadequate fluid/volume in circulatory system (hemorrhagic/non-hemorrhagic) - Respiratory insufficiency: Unable to breath adequate amount of O2
12-O4. A. Signs and symptoms of shock: compensated & decompensated Compensated shock: Early stage where body can still compensate for blood loss Decompensated shock: Late stage where blood pressure is falling *When shock has progressed to far, it is irreversible - Cardiogenic: - Obstructive:
12-O4. B. Signs and symptoms of shock: compensated & decompensated - Distributive: - Septic: - Neurogenic: - Anaphylactic: - Psychogenic:
12-O4. C. Signs and symptoms of shock: compensated & decompensated - Hypovolemic: - Respiratory insufficiency:
12-O5. A. Pt. assessment for shock Scene size up Initial assessment: Rapid exam(LOC),Life threats, transport, ABC &bleeds, Interventions -Quick initial general impression, consider c-spine, LOC AVPU Hx taking: Chief complaint, Med. Hx, pertinent negatives & loss of sensation, SAMPLE
12-O5. B. Pt. assessment for shock Secondary assessment: Repeat initial assessment, Focused assessment(consider neurologic assessment), Baseline vitals, Monitoring devices (BP & SpO2) Reassesment: Reassess- Vitals, Interventions, ABC & mental status
12-O6. A. Steps to follow in emergency care of pt. with various types of shock Precautions Control external bleeds - Dry sterile dressings/ pressure bandages Open airway Hold c-spine (If necessary) -> splint of LSB Check breathing/pulse Comfort, calm, reassurance (Fowlers/supine) Nothing by mouth (food/water)
12-O6. B. Steps to follow in emergency care of pt. with various types of shock Provide O2, assist ventilations, Airway control adjuncts - Monitor breathing Blankets for warmth Check vitals every 5 mins Limit scene time <1Omins
 

 



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