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National Ski Patrol, Outdoor Emergency Care, 5th©2012 by Pearson Education, Inc., Upper Saddle River, NJ
BRADY
Shock
Chapter 10
National Ski Patrol, Outdoor Emergency Care, 5th©2012 by Pearson Education, Inc., Upper Saddle River, NJ
BRADY
Anatomy and Physiology
Heart◦ Four chambers
Blood vessels◦ Arteries – away from the
heart◦ Veins – toward the heart
Blood
How the Heart Pumps Blood
National Ski Patrol, Outdoor Emergency Care, 5th©2012 by Pearson Education, Inc., Upper Saddle River, NJ
BRADY
What is Shock?
Failure of the circulatory system to maintain adequate blood flow to tissues
Leads to inadequate tissue perfusion in which cells do not receive sufficient O2 & nutrients
continued
National Ski Patrol, Outdoor Emergency Care, 5th©2012 by Pearson Education, Inc., Upper Saddle River, NJ
BRADY
Stages of Shock
Compensated shock Decompensated shock Irreversible shock
Important terms:◦ Tachypnea & tachycardia
continued
National Ski Patrol, Outdoor Emergency Care, 5th©2012 by Pearson Education, Inc., Upper Saddle River, NJ
BRADY
Types of Shock
Hypovolemic◦Results from a critical decrease in
circulating blood volume Caused by a loss of circulating blood
or internal body water
National Ski Patrol, Outdoor Emergency Care, 5th©2012 by Pearson Education, Inc., Upper Saddle River, NJ
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Types of Shock
continued
Cardiogenic◦Heart cannot adequately pump blood
The defect occurs within the heart itself
Examples?
National Ski Patrol, Outdoor Emergency Care, 5th©2012 by Pearson Education, Inc., Upper Saddle River, NJ
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Types of Shock
Distributive◦ Blood vessels lose their ability to
constrict appropriately 3 subtypes: septic, anaphylactic,
neurogenic
National Ski Patrol, Outdoor Emergency Care, 5th©2012 by Pearson Education, Inc., Upper Saddle River, NJ
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Types of Shock Septic
◦Caused by an infection known as sepsis Anaphylactic
◦ Severe allergic reaction Neurogenic
◦Caused by disruptions of the CNS
National Ski Patrol, Outdoor Emergency Care, 5th©2012 by Pearson Education, Inc., Upper Saddle River, NJ
BRADY
Types of Shock
Obstructive shock◦ Tension pneumothorax◦ Pericardial tamponade◦ Pulmonary embolism
National Ski Patrol, Outdoor Emergency Care, 5th©2012 by Pearson Education, Inc., Upper Saddle River, NJ
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Factors Affecting Shock
Age Concurrent illness or injury Pre-existing medical condition Mind-altering substances or
medications Prescription or over-the-counter
(OTC) medications
National Ski Patrol, Outdoor Emergency Care, 5th©2012 by Pearson Education, Inc., Upper Saddle River, NJ
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Patient Assessment
MOI◦ Scene size up◦Clues; suggestion possible shock
Classic signs◦ Tachycardia◦Hypotension◦ Tachypnea◦ Pale, cool, diaphoretic skin◦ Altered mental status
National Ski Patrol, Outdoor Emergency Care, 5th©2012 by Pearson Education, Inc., Upper Saddle River, NJ
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Patient Management
High flow oxygen Return to homeostasis Place in shock position Transport in head down position
National Ski Patrol, Outdoor Emergency Care, 5th Ed. ©2012 by Pearson Education, Inc., Upper Saddle River,
NJ
BRADY
Skill 10-1
Shock Management
National Ski Patrol, Outdoor Emergency Care, 5th©2012 by Pearson Education, Inc., Upper Saddle River, NJ
BRADY
OEC Skill 10-1 Shock Management (a) Assess scene safety and initiate Standard Precautions. Copyright Scott Smith
National Ski Patrol, Outdoor Emergency Care, 5th©2012 by Pearson Education, Inc., Upper Saddle River, NJ
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OEC Skill 10-1 Shock Management (b) Perform a primary assessment. Assess ABCDs and correct any problems found. Copyright Scott Smith
National Ski Patrol, Outdoor Emergency Care, 5th©2012 by Pearson Education, Inc., Upper Saddle River, NJ
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OEC Skill 10-1 Shock Management (c) Call for help and arrange for transport that includes ALS. Copyright Scott Smith
National Ski Patrol, Outdoor Emergency Care, 5th©2012 by Pearson Education, Inc., Upper Saddle River, NJ
BRADY
OEC Skill 10-1 Shock Management (d) Monitor the airway and administer high-flow oxygen. Copyright Scott Smith
National Ski Patrol, Outdoor Emergency Care, 5th©2012 by Pearson Education, Inc., Upper Saddle River, NJ
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OEC Skill 10-1 Shock Management (e) To prevent heat loss, keep the patient warm and dry. Copyright Scott Smith
National Ski Patrol, Outdoor Emergency Care, 5th©2012 by Pearson Education, Inc., Upper Saddle River, NJ
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OEC Skill 10-1 Shock Management (f) Place the patient with the head lower than the feet while maintaining spinal integrity. Copyright Scott Smith
National Ski Patrol, Outdoor Emergency Care, 5th©2012 by Pearson Education, Inc., Upper Saddle River, NJ
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OEC Skill 10-1 Shock Management (g) Provide for rapid transport. Copyright Selko
National Ski Patrol, Outdoor Emergency Care, 5th©2012 by Pearson Education, Inc., Upper Saddle River, NJ
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continued
Early recognition!!
Early recognition of the potential for shock is essential in reducing the number of deaths from this condition.