Shock

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Shock
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Shock

• OBJECTIVES
• Review the definition of shock
• Review the causes of shock
• Review the Signs and Symptoms
• Review the types of shock
• Review the treatment of shock

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Shock
Is inadequate circulation of blood to the
tissues. This results in a lack of Oxygen and
Glucose in the cells, which leads to a buildup of
acids and water within the cells
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Homeostasis

• The bodies ability to maintain a constant
  internal environment through positive and
  negative feedback
• Metabolism
• Aerobic
• The production of energy with an ample supply of
  oxygen
• Anaerobic
• The production of energy without oxygen

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Shock

• Some definitions
• Perfusion
• Circulation in and out the cells.
• Diffusion
• Movement of gases from an area high to low
  pressure
• Osmosis
• The movement of water from an area of low solute
  concentration to an area of high solute
  concentration

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Causes

• Failure of the
• Pump
• Pipe
• Fluid
• Quality
• Quantity

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Stages

• Stage 1 Vasoconstriction (15 blood loss)
• Reversible
• BP Normal
• HR Normal
• Stage 2 Capillary and Venule Opening (15 25)
• HR Increased
• RR Increased
• Cap refill Delayed
• Pulse pressure Decreased

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Stages

• Stage 3 Disseminated Intravascular
  Coagulation (25 35)
• BP Decrease
• Stage 4 Multiple Organ Failure (35 40)

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Stages

• Compensated (Stage 1 and 2)
• Uncompensated (Stage 3)
• Irreversible (Stage 4)

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Whos at Risk

• Age
• Elderly
• Children
• Health
• Preexisting disease
• General condition
• Medications

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Signs and Symptoms

• Tachycardia
• Tachypnea (Shallow)
• Pale, cold and clammy skin
• Weakness
• N/V
• Thirst
• Confusion
• Increasing Deep Respirations
• Low BP
• Unconsciousness
• Death

Stage 1 and 2
Stage 3 and 4
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Types of Shock

• Hypovolemic
• Cardiogenic
• Neurogenic (Spinal)
• Respiratory
• Metabolic
• Septic
• Psychogenic
• Anaphylactic

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Non-traumatic Shock
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Traumatic
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Cardiogenic Shock
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Severe Bleeding
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Bleeding

• Types
• Arterial
• Bright red, spurting
• Venous
• Dark red, steady flow
• Capillary
• Bright or Dark, Oozes

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Soft Tissue Wounds

• Incisions Sharp Cut
• Laceration Jagged Cut
• Avulsion Torn Flap
• Abrasion Scrape
• Puncture
• Contusion Bruise
• Hematoma Collection of blood

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Incision
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Laceration
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Avulsion
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Abrasion
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Puncture
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Bruising/Hematoma
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Controlling Bleeding

• Remember!
• RED Patient (PT)

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Controlling Bleeding

• Rest
• Elevation
• Direct Pressure
• Pressure Points
• Indirect Pressure
• Tourniquets
• Last Resort
• Check every 10 minutes
• Release every hour

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Bandages and Dressings

• DRESSINGS
• Used to stop bleeding and prevent contamination
• Sterile or as clean as possible
• Ensure it is large enough to cover the wound
• BANDAGES
• Used to hold the dressings in place
• Provide a barrier to unwanted items

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Amputations

• Wrap the amputated part in a moist dressing
• Place the part in a plastic bag (label it)
• Place in another plastic bag filled with ice (or
  cold water)
• Transport with patient if possible
• Remember Never place the amputated part directly
  on ice!

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Amputation
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And Remember.

• All Bleeding Will Stop
• Eventually!