shock: cycle “a” refresher shock nature’s prelude to death 2008 cycle “a” oec refresher
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Shock: Cycle “A” Refresher
ShockNature’s prelude to death
2008 Cycle “A” OEC Refresher
Shock: Cycle “A” Refresher
I Can:I Can:
Goals and ObjectivesGoals and Objectives
Define shock.
List the early and late signs of shock.
Describe the treatment for shock.
Shock: Cycle “A” Refresher
What is Shock?What is Shock?
Inadequate perfusion…
…What does this mean?
Lack of oxygen, other nutrients to body cells
The body needs oxygen to survive!
Shock: Cycle “A” Refresher
Blood PressureBlood Pressure
What brings oxygen to body tissues??Blood
What supports the delivery of blood??Blood Pressure
Shock: Cycle “A” Refresher
ShockShock
What is really happening in shock??
There is not enough blood pressure to adequately get oxygen to body tissues.
Shock: Cycle “A” Refresher
Compensated ShockTachycardiaTachypneaA narrowing of the difference between
the systolic and diastolic blood pressure (a.k.a - pulse pressure)
ShockShock
How do I identify that a patient is in shock??
Shock: Cycle “A” Refresher
ShockShock
How do I identify that a patient is in shock??
Decompensated ShockA drop in the systolic blood
pressure
Shock: Cycle “A” Refresher
ShockShock
Once the patient is in decompensated shock body cells begin to die.
This is a bad thing!!!!
Identify shock early before the patient has decompensated.
Shock: Cycle “A” Refresher
Types of ShockTypes of Shock
Hypovolemic:Hypovolemic: not enough volume
(e.g., bleeding, dehydration, vomiting, diarrhea)
Cardiogenic:Cardiogenic: not enough strength to push the volume
some causes of respiratory shock are actually cardiogenic shock (ex. Flash pulmonary edema from congestive heart failure)
Shock: Cycle “A” Refresher
Types of ShockTypes of Shock
NeurogenicNeurogenic (a.k.a. - Distributive): loss of tone in the blood vessels
(e.g., sepsis, severe infection, anaphylaxis, spinal cord injury, psychogenic)
Other reasons for shock:Other reasons for shock:A mechanical obstruction that prevents movement of blood (a.k.a. – Obstructive)
some causes of respiratory shock are actually obstructive shock (ex. pulmonary embolism)
Shock: Cycle “A” Refresher
HemorrhageHemorrhage
A cause of hypovolemic shock
In trauma, hemorrhage most common cause of shock !!!!
Caution: It is not the only reason for shock in trauma, but is definitely the most common reason.
Shock: Cycle “A” Refresher
HemorrhageHemorrhage
ExternalInternal
ChestAbdomenPelvis
Where can a patient bleed to death?
Shock: Cycle “A” Refresher
Don’t Forget to Look for Bleeding!
Signs & Symptoms of shockSigns & Symptoms of shock
Shortness of breathDizzyPainNausea
TachycardiaTachypneaDiaphoresisPaleDrop in systolic blood pressure (late finding)
Signs Symptoms
Shock: Cycle “A” Refresher
OEC Management of ShockOEC Management of Shock
Hemorrhagic Shock
Direct pressure Elevation Pressure points Tourniquet
(as a last resort)
External Bleeding
Shock: Cycle “A” Refresher
OEC Management of ShockOEC Management of Shock
Hemorrhagic Shock
Determine if this it occurring
Safely and rapidly transport
Internal Bleeding (chest, abdomen, pelvis)
Shock: Cycle “A” Refresher
OEC Management of Shock: all typesOEC Management of Shock: all types
Diagnose shock early
Stop bleeding
Give oxygen
Keep patient warm(Hypothermia makes
shock worse)
Transport
Shock: Cycle “A” Refresher
Remember…Remember…
See a drop in BP? You are way behind the eight ball!
Diagnose shock earlyDirect pressure to stop bleedingGive oxygenKeep patient warmTransport to definitive care
Shock: Cycle “A” Refresher
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