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

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• Perfusion requires   an intact cardiovascular system and a functioning respiratory system.  
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• 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)  
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• Shock (hypoperfusion) is   is the collapse and failure of the cardiovascular system, when blood circulation slows and eventually stops.  
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• 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.  
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• Blood contains   red blood cells, white blood cells, platelets, and a liquid called plasma.  
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• 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.  
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• The various types of shock are   cardiogenic, obstructive, septic, neurogenic, anaphylactic, psychogenic, and hypovolemic.  
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• 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.  
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• 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.  
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• Remember, by the time a drop in blood pressure is detected, shock is usually   in an advanced stage.  
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• 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  
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• Treating a pediatric or geriatric patient in shock is no different than   treating any other shock patient.  
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• 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.  
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• 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.  
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