Non-traumatic Shock

Question 1

Clinical Severity Prompts (3)

Answer 1

Tachycardia (PR > 100bpm)

Poor brain perfusion: restlessness, altered LOC

Poor skin perfusion: cold, pale, sewaty, capillary refill > 2 seconds

Question 2

History Prompts (5)

Answer 2

Onset

Events: vomiting/diarrhoea, infection, pregnancy, gastric/abdo pain

Relevant past history: palpatations, light-headed, fainting

Medication history

Allergies

Question 3

Airway - Assessment

Answer 3

Assess patency

Question 4

Airway - Intervention

Answer 4

Maintain airway patency

Question 5

Breathing - Assessment

Answer 5

Respiratoy rate and effort

SpO2

(Auscultation)

Question 6

Breathing - Intervention

Answer 6

Assist ventilation if required

Apply 02 to maintain SpO2 > 95%

Question 7

Circulation - Assessment

Answer 7

Skin temperature (touch)

Pulse - rate/rhythm

Capillary refill

Blood pressure

Cardiac monitor

Question 8

Circulation - Intervention

Answer 8

IV cannulation x 2/pathology

If SBP < 90 mmHg give IV/IO 0.9% NSCl 500ml bolus

Monitor vital signs frequently

Question 9

Disability

Answer 9

AVPU/GCS + pupils ⇒ monitor LOC

Finger prick BGL

Question 10

Measure and test

Answer 10

Repeat Primary Survey

Commence Secondary Survey

Pathology - bloods for FBC, UEC, group and hold (if required), venous blood gas, blood culture & serum lactate.

Measure Hb (iStat)

Temperature

U/A - urine hCG (women of childbearing age), urine culture

Fluid input/output - FBC, nil by mouth, insert IDC (hourly ouput)

PV Loss - Monitor

12-lead ECG

Chest x-ray (if available)