1. CREATED BY: Trauma - Shock

2. Shock Definition-reaction of body to failure of circulatory system to provide enough blood to all vital organs of body. Failure of perfusion or hypoperfusion. (ITP) Inadequate Tissue Perfusion Chances of survival are greatly increased if patient is treated within first hour of injury ("golden hour"). The Body develops shock through: 1.Heart-if heart fails to pump required blood volume efficiently, shock will develop. 2.Vessels-circulatory system must operate as a closed system. If vessels are cut, blood is lost and shock will develop. 3.Blood volume-there must be enough blood to fill vessels. If there is loss of volume or vessels enlarge so system is not filled, shock will develop.

3. Types of Shock 1.Hypovolemic-bleeding shock caused by blood loss or loss of plasma. 2.Cardiogenic-heart shock caused by heart failing to pump enough blood. 3.Neurogenic-nerve shock caused when nervous system is damaged from an injury and it cannot control diameter of blood vessels. 4.Anaphylactic-allergy shock, a life-threatening reaction caused by something to which patient is extremely allergic. 5.Psychogenic-fainting, disrupting proper blood flow to brain. 6.Metabolic-fluid shock caused by loss of body fluids. 7.Septic-bloodstream shock caused by infection.

4. Signs and Symptoms of Shock Symptoms include: a.Weakness b.Nausea c.Thirst d.Dizziness e.Restlessness and fear Signs of shock include: a.Entire body assessment-look for restlessness or combativeness, profuse external bleeding, vomiting or loss of body fluids, shaking and trembling. b.Altered mental status-patient may become disoriented, confused, unresponsive, faint or become unconscious. c.Breathing-shallow and rapid. d.Pulse-rapid and weak. e.Skin-pale, cool, and clammy (may be sweating profusely). f.Face-pale, often with blue color at lips, tongue, earlobes. g.Eyes-lackluster, pupils dilated.

5. Pattern of Shock 1.Increased pulse rate 2.Increased breathing rate 3.Restlessness or combativeness 4.Skin changes indicating possible shock 5.Rapid, weak pulse and labored, weakened respirations 6.Changes in mental status 7.Respiratory arrest, then cardiac arrest can develop

6. Prevention and Care for Shock 1.Alert 911/EMS dispatcher. 2.Perform scene size-up. 3.Perform initial assessment. (Keep patient's airway open and prevent forward tilting of head.) 4.Assist the patient in lying down and explain importance of remaining at rest. 5.Control external bleeding and splint fractures. 6.Keep patient warm but do not overheat. 7.Properly position patient. 8.Give the patient nothing by mouth. 9.Monitor vital signs. 10.Provide oxygen per local protocols.

7. Fainting 1.A mild form of shock that is usually self-correcting 2.Examine the patient for injury and keep him lying down. 3.Check blood pressure if you have the equipment. 4.May be a warning sign of more serious problems; assess and take a careful history. 5. Prevent fainting by having patient lower head between knees.