1. Provincial Reciprocity Attainment Program Shock

2. OBJECTIVES Review the definition of shock Review the causes of shock Review the Signs and Symptoms Review the types of shock Review the treatment of shock Shock

3. Is inadequate circulation of blood to the tissues. This results in a lack of Oxygen and Glucose in the cells, which leads to a buildup of acids and water within the cells Shock

4. The bodies ability to maintain a constant internal environment through positive and negative feedback Metabolism Aerobic  The production of energy with an ample supply of oxygen Anaerobic  The production of energy without oxygen Homeostasis

5. Some definitions… Perfusion  Circulation in and out the cells. Diffusion  Movement of gases from an area high to low pressure Osmosis  The movement of water from an area of low solute concentration to an area of high solute concentration Shock

6. Failure of the:  Pump  Pipe  Fluid Quality Quantity Causes

7. Stages Stage 1Vasoconstriction (15 % blood loss) Reversible BPNormal HRNormal Stage 2Capillary and Venule Opening (15 – 25%) HRIncreased RRIncreased Cap refillDelayed Pulse pressureDecreased

8. Stages Stage 3Disseminated Intravascular Coagulation (25 – 35%) BPDecrease Stage 4Multiple Organ Failure (35 – 40%)

9. Stages Compensated (Stage 1 and 2) Uncompensated (Stage 3) Irreversible (Stage 4)

10. Who’s at Risk Age  Elderly  Children Health  Preexisting disease  General condition Medications

11. Tachycardia Tachypnea (Shallow) Pale, cold and clammy skin Weakness N/V Thirst Confusion Increasing Deep Respirations Low BP Unconsciousness Death Stage 1 and 2 Stage 3 and 4 Signs and Symptoms

12. Hypovolemic Cardiogenic Neurogenic (Spinal) Respiratory Metabolic Septic Psychogenic Anaphylactic Types of Shock

13. Non- traumatic Shock

14. Traumatic

15. Cardiogenic Shock

16. Severe Bleeding

17. Types:  Arterial Bright red, spurting  Venous Dark red, steady flow  Capillary Bright or Dark, Oozes Bleeding

18. IncisionsSharp Cut LacerationJagged Cut AvulsionTorn Flap AbrasionScrape Puncture ContusionBruise HematomaCollection of blood Soft Tissue Wounds

19. Incision

20. Laceration

21. Avulsion

22. Abrasion

23. Puncture

24. Bruising/Hematoma

25. Remember! RED Patient (PT) Controlling Bleeding

26. R est E levation D irect Pressure P ressure Points  Indirect Pressure T ourniquets  Last Resort  Check every 10 minutes  Release every hour Controlling Bleeding

27. DRESSINGS  Used to stop bleeding and prevent contamination  Sterile or as clean as possible  Ensure it is large enough to cover the wound BANDAGES  Used to hold the dressings in place  Provide a barrier to unwanted items Bandages and Dressings

28. Wrap the amputated part in a moist dressing Place the part in a plastic bag (label it) Place in another plastic bag filled with ice (or cold water) Transport with patient if possible Remember: Never place the amputated part directly on ice! Amputations

29. Amputation

30. And Remember…. All Bleeding Will Stop… Eventually!