PREVIEW OF

EMT/EMR SHOCK & RESUSCITATIONPOWERPOINT TRAINING

PRESENTATION

ETHICAL ISSUES IN RESUSCITATION

Withholding resuscitation attemptsIrreversible deathDo Not Resuscitate (DNR) orders

Provide emotional support for family

IRREVERSIBLE DEATH

Signs includeDecapitationOther obvious mortal injuriesDecompositionPostmortem lividityPostmortem rigidity

Many areas require EKG confirmation

DO NOT RESUSCIATATE ORDERS

Advanced directive created by doctor and patientNormally is required to be shown at time of death Indicates patients wishes not to be resuscitated

EMOTIONAL SUPPORT FOR FAMILY

Ask if they need support from support fromPastor-either family or on callOther family membersSome employers provide “Employee

Assistance Programs” (EAP) and have a 24 hour phone assistanceEMT’s must maintain dignity & decorum

RESPIRATORY SYSTEM

Fresh oxygen to enter the lungs and blood supply

Respiratory waste products (CO2) to leave the blood and lungs

CARDIOVASCULAR SYSTEMVascular System

Arteries carry blood to tissuesVeins carry blood to heartHeart contraction can be felt as a pulse RadialCarotidBrachialFemoral

Veins (blue)

RESPIRATORY FAILURE

Definition- Reduction of breathing to the point where oxygen intake is not sufficient to support life

RESPIRATORY ARREST

DefinitionCondition that respirations have stopped

and can shortly lead to cardiac arrest if not immediately treated

GENERAL REASONS FOR THE HEART TO STOP BEATING

Sudden death and heart diseaseBreathing stops, especially in infants and childrenMedical emergenciesTrauma

CHEST COMPRESSIONS

Factors which decrease effectivenessCompression that are too shallowSlow compression rateSub-maximum recoilFrequent interruptions

SHOCK(POOR PERFUSION)

Results from inadequate delivery of oxygenated blood to body tissues

DEFINITION

Perfusion is the passage of blood and oxygen and other essential nutrients to the body’s cells

While delivering these essentials to the body’s cells, the circulatory system is also

removing waste such as carbon dioxide from the cells

DEFINITION

Shock is a state of hypoperfusion, or inadequate perfusion of blood through body tissues

Hypoperfusion can lead to death if not corrected

BLOOD VOLUME BY SIZE

Adult- 4-5 liters (females may be slightly higher)Child- 2.4 Liters (66 pounds)Infant- 0.8 Liter ( 22 pounds)

Volume is regulated by kidneys

ANATOMY & PHYSIOLOGY REVIEW

Heart & blood vesselsPhysiology of respiration

Gas exchangeAlveolar levelTissue level

CirculationPulmonarySystemic

HEART & BLOOD VESSELS

PULMONARY CIRCULATION

Is the portion of the cardiovascular system that carries blood between the heart and the lungs

DISRUPTIONS THAT CAN CAUSE SHOCK

Inadequate fluid/blood – blood/water lossFailing pump/heart

Disease or injury to conduction systemDamage to cardiac muscle

Leaky or dilated container/vesselsLoss of nervous controlSevere allergic reactionsMassive infectionHypothermia

COMPENSATED SHOCK

Earliest phaseUp to 5 to 15 % blood lossBody compensates by activating the

sympathetic nervous system

IRREVERSIBLE SHOCK

Rapid deterioration of the cardiovascular system

Greater blood shunting to heart & brainCell death begins which will progress over

several days

S & S OFIRREVERSIBLE SHOCK

Marked decrease in level of responsivenessDecreased respiratory rateProfound respiratory rateDecrease in pulse ratePatient feels impending doom

SHOCK DUE TO FLUID LOSS

Hypovolemic (hypovolemia)ExamplesSigns and symptoms

CARDIOGENIC SHOCK(PUMP FAILURE)

Caused by profound failure of the heartSevere MISevere heart failureTrauma to the heart

There is good peripheral vascular resistance & adequate blood volume, but the heart is not pumping properly

NEUROGENIC SHOCK

The nervous system is no longer able to control the diameter of the blood

vessels leading to hypovolemiaUsually from severe brain or CNS injury

SEPTIC SHOCK(SEPSIS)

Caused by an infection causing massive vasodilation

Blood plasma is lost through the vessel wallsResults in hypovolemia

PEDIATRICS

Common causes of shockTraumaFluid lossInfectionAnaphylaxisCongenital heart diseaseChest wall injury

GERIATRICS

AssessmentBody system changes affecting

presentations of shockVital sign changesAirwayBreathingCirculationSkin

MEDICATIONS MAY MASK SHOCK SYMPTOMS

Beta BlockersPrevent increase in heart rate

Decompsensation will be more will happen more quickly due to inability to raise heart rate & constrict blood vessels

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