Lesson 5: Shock and Heart Attack

Objectives Define Shock and discuss stages List signs of shock Describe when shock is threat to life Demonstrate treatment for shock Define heart attack List signs and symptoms of a heart attack Demonstrate care for a heart attack Describe long term care for a heart attack patient

Shock Cardiovascular system is challenged. Insufficient oxygen to brain and other body parts Can occur from large variety of injuries/illnesses Loss of body fluids Allergic reaction Loss of blood pressure Psychogenic shock (fainting) Heart Attack

Shock Signs and Symptoms LOR (level of Responsiveness): anxious, restless, or disoriented Heart rate may be rapid, weak, or irregular Respiratory Rate rapid, shallow Skin Color,temp,moisture: pale, cool, clammy (may be pink if allergic reaction) Nausea

Later Stages of Shock LOR continues to decrease Patient becomes lethargic, apathetic, eventually unresponsive Heart rate (radial=wrist) grows more rapid and weak, may disappear

Care for Shock Always care for shock until patient is in normal state Unmanaged Shock can lead to death Options for caring limited in Wilderness Early recognition is essential

Care for Shock Identify causes, such as bleeding, treat causes Keep patient calm Keep patient lying down or comfortable Maintain open airway Elevate patient’s feet about 12 inches Monitor vital signs Give sips of cool water to prevent dehydration if conscious (4 oz/20 min) Maintain patient’s normal body temp

Position for Shock

Checking and Caring for a Heart Attack Signs and Symptoms Pain in center of chest Pressure in chest Pain on left side may in shoulder arm, jaw Nausea, sweating, shortness of breath Denial of the possibility of a heart attack Unexplained fatigue Sudden, sharp short lived pain outside breastbone

Care for a Heart Attack Keep him/her physically and emotionally calm Do not allow patient to walk Call for help immediately Help patient self administer 325 mg aspirin if they can swallow (not coated aspirin) If patient has strong radial pulse and has Nitro prescription, help them self-administer If unconscious and no movement or breathing, immediately start CPR. Use AED if available

Making Difficult Decisions For delayed help CPR, how long do you try? Keep in mind Decision is your’s and based on info you have Some people die because no advanced care is available, no matter what you do CPR does not sustain life indefinitely Survival chances not good if direct injury to heart Better chances for hypothermia/lightning strike

Making Difficult Decisions General Rules Continue CPR until obvious signs of life are observed Another trained person arrives and takes over EMS personnel arrive and take over You are too exhausted to continue The scene becomes unsafe

Guidelines for Evacuation Deciding whether to go slow or fast is important part of the care for shock/heart attack Evacuate if patient is not stable GO FAST for any patient with Decreased mental status Worsening vital signs, especially increased heart rate Any you believe is having a heart attack