Shock Types, Signs, and Emergency Care: EMT Basic Program

Aerobic metabolism

Energy using oxygen into cells.

Anaerobic metabolism

Energy not using oxygen; 18 times less effective than aerobic and produces acids.

Cardiac Output

Amount of output per minute.

Stroke Volume

The amount ejected in one contraction of heart.

Perfusion

Movement.

Hypoperfusion

Inadequate movement of blood; also known as SHOCK.

Shock

Defined as inadequate tissue perfusion.

Hypotension

Low BP.

Fick Principle

Getting oxygen into lungs, into body, into cells, back to lungs and out.

Arteries

The most muscular vessels that carry blood away from heart.

Capillaries

The smallest vessels where gas exchange takes place.

Veins

Returns blood to heart and have valves to prevent back flow.

Red Blood Cells

Produced in bone marrow and contain hemoglobin that bonds the oxygen.

White Blood Cells

Fight infection.

Platelets

Produce coagulation when in contact with air.

Plasma

The fluid of blood (55%); not a formed element of blood.

Hypovolemic Shock

Loss of volume; causes include diarrhea, heat stroke, vomiting.

Cardiogenic Shock

Failure of the heart to pump; cannot keep cardiac output up.

Septic Shock

Infection that goes systemic throughout the body; irritates vessels causing BP drop.

Anaphylactic Shock

Severe allergic reaction causing vessels to leak and BP to drop.

Neurogenic Shock

Spinal cord severed causing blood vessels to dilate and BP to drop.

Psychogenic Shock

Not a true shock; known as syncope; transient lack of blood to the brain.

Critical Blood Loss for Adults

Can lose 1000cc before it is considered serious.

Critical Blood Loss for Children

Can lose 500cc before it is considered serious.

Critical Blood Loss for Infants

Can lose 250cc before it is considered serious.

Quick Blood Pressure Check

Adult only; radial pulse at least 80 systolic, femoral pulse at least 70 systolic, carotid pulse at least 60 systolic.

Core Pulses

Central pulses: carotid, femoral, apical.

Apical Pulse

When you listen for the lub-dub of the heart pumping.

Three Phases of Shock

Defined by blood pressure: compensated (BP above 90 systolic), decompensated (BP less than 90 systolic), irreversible (acid killing organs).

Signs and Symptoms of Early Shock

Restlessness/anxiety, fast and strong heart rate, fast and deep respirations, dilated pupils, sweaty skin.

Signs and Symptoms of Late Shock

Fast but weak heart rate, fast but shallow respirations, feeling of doom, delayed capillary refill.

Signs and Symptoms of Irreversible Shock

Unresponsive, death or organ failure.

Care for Shock

Lay flat or elevate legs, cover to keep warm, place on high flow oxygen, keep calm.

PASG (Pneumatic Anti-Shock Garment)

Helps control major bleeding and stabilize a fractured pelvis; only 250cc is pushed from the legs to the chest.