Shock (S-138)

Question 1

Protocol Number

Answer 1

S-138 7/1/2015

Question 2

BLS Treatment

Answer 2

O2 Saturation PRN
O2 and/or Ventilate PRN
Control obvious external bleeding
Treat associated injuries
NPO, anticipate vomiting
Remove any transdermal patch

Question 3

ALS Treatment

Answer 3

Monitor EKG
IV/IO SO
Capnography SO PRN

Question 4

ALS Treatment (suspected cardiac etiology)

Answer 4

250ml fluid bolus IV/IO without rales SO
MR x1 to maintain BP ≥ 90 SO

If BP refractory after second fluid bolus:
Dopamine 400mg/250ml @ 10-40 mcg/kg/min IV/IO drip
Titrate BP ≥ 90 BHO

Question 5

ALS Treatment (hypovolemic (nontraumatic))

Answer 5

500ml fluid bolus IV/IO SO

MR to maintain BP ≥ 90 SO

Question 6

ALS Treatment (hypovolemic (suspected AAA))

Answer 6

500ml fluid bolus IV/IO SO

MR to maintain BP ≥ 80 SO

Question 7

ALS Treatment (suspected Anaphylactic, Neurogenic)

Answer 7

500ml fluid bolus IV/IO SO
MR to maintain BP ≥ 90 SO

If BP refractory to fluid boluses:
Dopamine 400mg/250ml @ 10-40 mcg/kg/min IV/IO drip
Titrate BP ≥ 90 BHO

Question 8

ALS Treatment (sepsis)

Answer 8

Treat as per Sepsis Protocol (S-143)

Question 9

Shock is defined by the following: (age ≥ 15 years):

Answer 9

Systolic BP < 80mmHg OR
Systolic BP 90 mmHg AND exhibiting any of the following signs of inadequate perfusion:
1. altered mental status (decreased LOC, confusion, agitation)
2. tachycardia
3. pallor
4. diaphoresis