1. Lesson 5: Shock & Heart Attack Emergency Reference Guide p. 67-69

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. What is Shock? Cardiovascular system is challenged Insufficient oxygen to brain & other body parts What can cause Shock? –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. Position for Shock

9. 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

10. 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

11. 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

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

13. 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

14. Questions??? What else could you add to your First Aid Kit?