1. Lesson 5: Shock & Heart Attack

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

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

4. Shock Signs & Symptoms LOR (level of Responsiveness):
Anxious, restless, or disoriented
Heart rate may be rapid, weak, or irregular
Respiratory rate rapid, shallow
Skin Color -Temperature - Moisture:
Pale, cool, clammy (may be pink, if allergic reaction)
Nausea

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

6. 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

7. Care for Shock (cont’d.)
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. every 20 min.)
Maintain patient’s normal body temperature

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

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

10. 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

11. Making Difficult Decisions (cont’d.)
General Rules
Continue CPR until:
Obvious signs of life are observed
Another trained person arrives & takes over
EMS personnel arrive & take over
You are too exhausted to continue
The scene becomes unsafe

12. 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
Anyone you believe is having a heart attack