Understanding Shock
What is shock?
A condition in which the circulatory system fails to provide adequate oxygen and nutrients to the body tissues.
What type of shock results from inadequate circulating blood volume?
Hypovolemic shock.
Name one common early sign of shock.
Tachycardia (rapid heart rate).
What is one of the first priorities when assessing a critically ill patient?
Identify and manage immediate life threats.
What is the priority when severe external bleeding is found?
Control the bleeding promptly.
What is another term commonly used to describe inadequate tissue perfusion?
Hypoperfusion.
What type of shock occurs when the heart cannot pump effectively enough to maintain adequate circulation?
Cardiogenic shock.
What happens to the skin in many patients experiencing shock?
It may become pale, cool, clammy, or diaphoretic.
What should an EMS provider look for when assessing a trauma patient for hemorrhagic shock?
Evidence of external and internal bleeding along with signs of inadequate perfusion.
Why should a patient in shock be protected from heat loss?
Hypothermia can worsen coagulopathy and contribute to deterioration, particularly in trauma patients.
What organ is primarily responsible for pumping blood throughout the body?
The heart.
What category of shock results from abnormal blood-vessel dilation or distribution of blood?
Distributive shock.
Why can a patient be in shock even when their blood pressure is still normal?
The body can initially compensate by increasing heart rate and vascular tone, maintaining blood pressure despite inadequate tissue perfusion.
What does capillary refill potentially tell an EMS provider?
It can provide information about peripheral perfusion, although it should not be used alone to determine whether shock is present
What is an important treatment principle for shock?
Identify and treat the underlying cause while supporting airway, breathing and circulation.
Why is shock considered a life-threatening emergency?
Prolonged inadequate prefusion can cause cellular dysfunction, organ failure, and death.
What are three major forms of distributive shock?
Septic, anaphylactic, and neurogenic shock.
A patient becomes restless, anxious, and confused after significant blood loss. What might these changes indicate?
Possible worsening cerebral perfusion and developing shock.
What three components make up the classic trauma assessment approach often used by EMS providers.
Primary assessment, secondary assessment, and ongoing reassessment.
A patient with suspected shock suddenly becomes unresponsive and stops breathing normally. What should the EMS provider do?
Immediately reassess and manage the airway and breathing, begin appropriate resuscitation according to current protocols, and use an AED/defibrillator when indicated.
What can happen to the cells when they do not receive enough oxygen?
They shift toward anaerobic metabolism, producing less energy and contributing to metabolic acidosis.
A patient has severe blood loss following trauma. Which type of shock should the EMT or AEMT suspect?
Hemorrhagic hypovolemic shock.
Why is trending a patient's vital signs important when evaluating for shock?
Changes over time can reveal worsening perfusion even when a single set or vital signs appears relatively normal.
Why should an EMS provider continually reassess a patient in shock?
Shock can progress rapidly, and the patient's condition and response to treatment can change over time.
Your patient is showing signs of shock after major trauma. Name several priorities of prehospital care.
Address life threats, control hemorrhage, support airway and breathing/oxygenation as indicated, prevent heat loss, treat the underlying cause when possible, reassess frequently, and provide timely transport.