Chapter 7Shock

Introduction to Shock

• Perfusion− Adequate blood and oxygen are provided to

all cells in the body.• Hypoperfusion

− The cardiovascular system fails.− Blood circulation eventually ceases.

Damage Caused by Shock

• Brain− 4 to 6 minutes

• Abdominal organs− 45 to 90 minutes

• Skin and muscle cells− 3 to 6 hours

Perfusion Triangle

• Think of the circulatory system as having three components.− Heart (pump)− Blood vessels (pipes)− Blood (fluid)

Perfusion Triangle

• Shock occurs when one or more of the sides are not working properly.

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Causes of Shock

• Cardiovascular− Pump failure

• Cardiogenic shock− Loss of fluid or

blood• Hypovolemic shock

or hemorrhagic shock

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Causes of Shock

• Cardiovascular (cont’d)− Poor vessel

function• Neurogenic shock

− Combined vessel and content failure

• Septic shock© Jones & Bartlett Learning.

Causes of Shock

• Noncardiovascular− Respiratory

insufficiency• Chest injury• Airway obstruction

− Anaphylactic shock• Medications• Food• Insect stings

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Causes of Shock

• Noncardiovascular (cont’d)− Psychogenic shock

• Fainting, or syncope• Causes include fear, bad news, and unpleasant

sights.

The Progression of Shock

• Compensated shock

• Decompensated shock

• Irreversible shock

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Shock: What to Look For

• Altered mental status• Pale, cold, and clammy skin• Pale or cyanotic lips and/or nail beds• Nausea/vomiting• Rapid breathing and heart rate• Unresponsiveness when shock is severe

Shock: What to Do

• Treat injuries.• If responsive and

breathing normally, keep the person flat on his or her back.

• If no sign of injury, raise the feet 6–12 inches.

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© Jones & Bartlett Learning.

Shock: What to Do

• If unresponsive, roll the person onto his or her side.

• Prevent the loss of body heat.

• Call 9-1-1.• Do not give anything

to eat or drink.

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Anaphylaxis: What to Look For

• Shortness of breath• Swelling of tongue, mouth, nose• Intense itching• Flushed skin or swollen face• Sneezing, coughing, wheezing• Tightness and swelling in the throat• Tightness in the chest

Anaphylaxis: What to Look For

• Increased heart rate• Cyanosis• Dizziness• History of previous severe allergic

reactions• Medical identification tag

Anaphylaxis: What to Do• Call 9-1-1.• Monitor breathing• If the person has an epinephrine auto-

injector, help administer it.• If the person can swallow, give an

antihistamine.

Using an Epinephrine Auto-Injector

• Find the injection site on the outer midthigh.

• Remove the safety cap. © Jones & Bartlett Learning.

© Jones & Bartlett Learning.

Using an Epinephrine Auto-Injector

• Push against the outer midthigh.

• Hold in place for 10 seconds.

• Pull the auto-injector straight out from the leg.

• Rub the area for 10 seconds.

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Mild Allergic Reaction: What to Look For

• Red, itchy eyes• Itchy, sneezing, runny nose• Rash on skin, usually on one part of the

body

Mild Allergic Reaction: What to Do

• Help the person:− Self-administer his or her asthma “rescue”

inhaler− Take an antihistamine

Fainting: What to Do

• If a person suddenly collapses:− Check breathing.− If breathing stops, call 9-1-1 and give CPR.− If person is breathing:

• Keep the person flat on his or her back.• Monitor breathing; if it stops, give CPR.• Check and treat any injuries.• Wipe the person’s forehead with a cool, wet cloth.

Fainting: What to Do• If a person is about to faint:

− Prevent a hard fall.• If you feel faint:

− Lie down or sit down.− Do not place your head between your knees.