Chapter 7

Shock

Introduction to Shock

• Perfusion• Adequate blood and oxygen are provided to

all cells in the body.

• Hypoperfusion• The cardiovascular system collapses and

fails.• Blood circulation decreases and eventually

ceases.

Damage Caused by Shock

• Brain • 4 to 6 minutes

• Abdominal organs• 45 to 90 minutes

• Skin and muscle cells• 3 to 6 hours

Perfusion Triangle

• Shock occurs when one or more of the sides is not working properly.

Causes of Shock (1 of 4)

• Cardiovascular• Pump failure

• Cardiogenic shock

• Content failure• Hypovolemic shock

or hemorrhagic shock

Causes of Shock (2 of 4)

• Cardiovascular (cont’d)• Poor vessel

function• Neurogenic shock

• Combined vessel and content failure

• Septic shock

Causes of Shock (3 of 4)

•Noncardiovascular• Respiratory

insufficiency• Chest injury• Airway obstruction

• Anaphylactic shock

• Medications• Food• Insect stings

Causes of Shock (4 of 4)

•Noncardiovascular (cont’d)• Psychogenic shock

• Fainting, or syncope• Causes include fear, bad news, and

unpleasant sights.

The Progression of Shock (1 of 2)

•Compensated shock• The body can still compensate for blood loss.

•Decompensated shock• Late stage of shock• Falling blood pressure

•Irreversible shock• Final stage• Terminal

Progression of Shock (2 of 2)

General Care for Shock (1 of 6)

• Monitor breathing.• Begin cardiopulmonary resuscitation

(CPR), if necessary.

• Control external bleeding.

General Care for Shock (2 of 6)

Position the victim:•If spinal injury is not suspected, elevate the head.

General Care for Shock (3 of 6)

Position the victim (cont’d):•An unresponsive or stroke victim should be placed in the recovery position.

General Care for Shock (4 of 6)

Position the victim (cont’d):•Use a half-sitting position for victims with breathing difficulties, chest injuries, or heart attack.

General Care for Shock (5 of 6)

Position the victim (cont’d):•If spinal injury or leg fracture is suspected, keep the victim flat.

General Care for Shock (6 of 6)

• Loosen tight clothing at the neck, chest, and waist.

• Splint bone or joint injuries.

• Keep the victim warm.

• Handle the victim gently.

• Seek immediate medical care.

General Care for Anaphylaxis

• Call 9-1-1 immediately.

• Monitor breathing.

• Administer epinephrine.

Administering Epinephrine Auto-Injector (1 of 3)

• Check the expiration date.

• Remove the safety cap.

Administering EpinephrineAuto-Injector (2 of 3)

• Support the victim’s thigh.

• Place the injector between the hip and knee on the victim’s thigh.

• Push the injector firmly.

• Hold for 10 seconds.

Administering EpinephrineAuto-Injector (3 of 3)

• Reinsert, needle first.

• Dispose of properly.

Care for Psychogenic Shock(Fainting) (1 of 3)

If you feel faint:•Lie down or sit down.•Do not place your head between your knees.

Care for Psychogenic Shock(Fainting) (2 of 3)

If someone else faints:•Check for breathing.•Begin CPR and call 9-1-1 if necessary.•Keep the victim flat.•Raise legs 6 to 12 inches unless an injury is suspected.•Check for possible head and spine injuries.

Care for Psychogenic Shock(Fainting) (3 of 3)

If someone else faints (cont’d):• If weakness, dizziness, or pain is present during

walking, suspect a head injury.• Call 9-1-1 and treat for possible spine injury.• Check and treat injuries related to falling.• Allow fresh air to reach the victim.