Shock

Question 1

What is shock?

Answer 1

Shock is a medical emergency that occurs when the organs and tissues of the body are not receiving an adequate flow of blood. Shock is also described as inadequate perfusion.

Question 2

What are the signs of shock?

Answer 2

Rapid, weak heartbeat*
Rapid breathing*
Pale, gray, cool or moist skin*
Unresponsive to confused, restless or irritable*
Nausea or vomiting*
Excessive thirst*
*Note: Signs and symptoms with a * require immediate emergency medical treatment.

Question 3

What is stage 1 of shock?

Answer 3

Compensated or nonprogressive

In Stage I shock low blood flow (perfusion) is first detected, a number of systems are activated in order to maintain/restore perfusion. The result of that activation is that the heart beats faster (tachycardia), breathing is faster (tachypnea) the blood vessels throughout the body become smaller in diameter (vasoconstriction), and the kidneys work to retain fluid in the circulatory system

Question 4

What is stage 2 of shock?

Answer 4

Decompensated or progressive

In Stage II of shock, these compensation methods begin to fail. The systems of the body are unable to improve perfusion any longer, and the patient’s symptoms reflect that fact. Oxygen deprivation in the brain causes the patient to deteriorate to V, P, U on the AVPU scale. Heart rate, breathing rate are still above normal and blood pressure may be close to normal or below normal.

Question 5

What is stage 3 of shock?

Answer 5

Irreversible

In Stage III of shock, the length of time that poor perfusion has existed begins to take a permanent toll on the body’s organs and tissues. The heart’s functioning continues to spiral downward, and the kidneys usually shut down completely.

Question 6

What are the 4 major categories of shock?

Answer 6

Cardiogenic shock: meaning problems associated with the heart’s functioning

Hypovolemic shock: meaning that the total volume of blood available to circulate is low

Septic shock: caused by overwhelming infection, usually by bacteria

Anaphylactic shock - caused by an overwhelming allergic reaction, usually caused by a systemic response to a bee sting, food allergen, or other types of allergens.

Question 7

What is the treatment for shock?

Answer 7

• Treat the reason, per scope of practice (i.e. tourniquet or epi pen)
• Apply oxygen - 15 lpm on a NRB mask
• Move patient to supine
• Keep patient warm (turn on heater in ambulance, and cover patient with blanket)
• Call for immediate transport
• Monitor closely (unstable patient)