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Flashcards in Shock Deck (16)
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1

Define Shock

Shock is a condition characterised by impaired cellular function as a result of a reduction in the effective circulating blood volume.

This causes inadequate tissue perfusion.

2

Patient Risk Groups

Haemorrhages, injuries or fractures.
Heart conditions.
Burns & Scalds.
Elderly patients.
Pregnant Patients.

3

Types of Shock

Hypovolaemic
Cardiogenic
Neurogenic
Septic
Anaphylactic

4

Hypovolaemic shock

inadequate volume of blood.
(whole blood loss, plasma loss, electrolyte loss, water loss)

5

Cardiogenic shock

Failure of pump.
(heart failure, myocardial infarction, myocardium, tension pneumonia, cardiac tamponade)

6

Neurogenic shock

Loss of vasomotor tone.
(high spinal cord injury, poisons, fainting)

7

Septic/toxic Shock

Bacteriological Septicaemia.
(meningococcal meningitis, peritonitis)

8

Anaphylactic shock

A reaction which reduces peripheral resistance and venous return.

9

Shock recognition

Shock develops in four stages which relate to the body's compensatory mechanisms.

10

normal blood volume (relating to patient =>12yr)

75mls / kg

11

Shock stage one (relating to patient =>12yr)

up to 15% volume loss.
pallor of skin
normal capillary refill: ,2seconds
pulse rate in excess of 100bpm
no change in systolic or diastolic blood pressure.

12

Shock stage two (relating to patient =>12yr)

15-30% volume loss.
pallor & cool, clammy skin
extended time for capillary refill
pulse rate in excess of 100bpm
increased respiratory rate
narrowing pulse pressure
normal systolic but elevated diastolic blood pressure.

13

Shock stage three (relating to patient =>12yr)

30-40% volume loss.
Anxiety, restlessness and agitation
pulse rate in excess of 120bpm
falling systolic BP to 100mmHg or less

14

Shock stage four (relating to patient =>12yr)

over 40% volume loss.
moribund appearance
central cyanosis
altered level of consciousness
marked tachycardia, weak pulse
signs of respiratory distress - air hunger
systolic blood pressure of 70mmHG or less

15

Shock management

Safety.
Open airway.
Administer high % O2.
If conscious position patient flat with head and shoulders slightly raised.
If unconscious position patient in stable side position.
Where possible raise lower limbs.
Treat other injuries and bleeding.
Do not overheat or allow to get cold.
Avoid rough handling.
Constant reassurance.
Constant observations.
Nil by mouth.
Transport quickly but smoothly.
paramedic intervention.

16

Shock - paramedic/medical help

All types of shock can be life-threatening so you must be able to quickly assess the situation and the need to request backup.

Remember to take into account the condition of the patient, time for assistance to arrive and the distance to hospital.