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Shock Nature’s prelude to death. 2008 Cycle “A” OEC Refresher. Goals and Objectives. I Can:. Define shock. List the early and late signs of shock. Describe the treatment for shock. What is Shock?. Inadequate perfusion…. …What does this mean?. Lack of oxygen, other nutrients to body cells. - PowerPoint PPT Presentation
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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