15. Shock and Resuscitation

anaphylactic shock

A shock (hypoperfustion) state that results from dilated and leaking blood vessels related to severe allergic reaction.

asystole

A heart rhythm indicating absence of any electrical activity in the heart. Also know as a flatline.

automated external defibrillator (AED)

A device that can analyze the electrical activity or rhythm of a patient's heart and deliver an electrical shock (defibrillation) if appropriate.

burn shock

A form of nonhemorrhagic hypobolemic shock resulting from a burn injury.

cardiac arrest

The cessation of cardiac function with the patient displaying no pulse, no breathing, and unresponsiveness.

cardiogenic shock

Poor perfusion resulting from an ineffective pump function of the heart, typically the left ventricle.

Chain of Survival

A series of six crucial, rapid-response steps that maximize survival from cardiac arrests.

The five links of the adult chain are

1. immediate recognition and Aviation

2. early CPR

3. rapid defibrillation

4. effective advanced life support

5. integrated post-cardiac-arrest care.

The five links of the pediatric chain are

1. prevention of arrest

2. early high-quality CPR performed by bystanders

3. rapid activation of EMS or other emergency medical responders

4. effective advanced life support and rapid transport to an appropriate medical facility

5. integrated post-cardiac-arrest care.

compensatory shock

The stage of shock in which a cascade of organ and gland stimulation and hormones occurs to increase the blood pressure, restore arterial wall tension, and maintain a near normal blood pressure and perfusion of the vital organs.

decompensatory shock

An advanced stage of shock in which the body's compensatory mechanism can no longer a blood pressure and perfusion of the vital organs.

hemorrhagic shock

Shock from the loss of whole blood from the intravascular space.

hypoperfusion

The inadequate perfusion of cells, tissue, and organs with oxygen and other nutrients, resulting in cell, tissue, and organ dysfunction. Also called shock.

hypovolemic shock

Shock caused by the loss of blood or fluid from the intravascular space resulting in a low blood volume.

metabolic shock

A dysfunction in the capability of oxygen to diffuse into the blood, be carried by hemoglobin, off-loaded at the cells, or be used effectively by the cell for metabolism.

multiple organ dysfunction syndrome (MODS)

Failure of multiple organs throughout the body from extreme and prolonged hypoxia, altered metabolism, and elevated carbon dioxide and acid levels associated with decompensatory shock.

nonhemorrhagic hypovolemic shock

Shock caused by loss of fluid from the intravascular space with red blood cells and hemoglobin remaining within the vessels.

obstructive shock

A poor perfusion state resulting from a condition that obstructs forward blood flow.

pulse-less electrical activity (PEA)

A condition in which the heart generates relatively normal electrical rhythms but fails to perfuse the body adequately because of a decreased or absent cardiac output from cardiac muscle failure or blood loss.

respiratory shock

Failure to oxygenate blood adequately, often due to airway obstruction, pneumothorax, or severe pneumonia, leading to inadequate tissue oxygenation.

resuscitation

Bringing a patient back from a potential or apparent death; an attempt to restore normal or adequate physiologic function.

return of spontaneous circulation (ROSC)

Return of a spontaneous pulse during the cardiac resuscitation.

sepsis

Exaggerated inflammatory response to an infection that overwhelms the body's normal defense and regulatory systems, causing a disruption in cell and organ function. Also called sepsis syndrome.

sepsis syndrome

Life-threatening, dysregulated immune response to infection causing acute organ dysfunction.

septic shock

A type of distributive shock caused by sepsis, a severe inflammatory response to infection.

shock

The inadequate perfusion of cells, tissue, and organs with oxygen and other nutrients, resulting in cell, tissue, and organ dysfunction.

sudden death

Death of a patient within 1 hour of the onset sf signs and symptoms.

survival

Term applied to a patient who survives cardiac arrest to be discharges from the hospital.

total downtime

The total time from when a patient goes into cardiac arrest until he is delivered to the emergency department.

unwitnessed cardiac arrest

a cardiac arrest, with the patient already unresponsive, apneic, and pulseless, when EMS arrives on the scene.

vasogenic shock

A type of distributive shock that results from massive vasodilation. Also called nuerogenic shock.

ventricular fibrillation (VF or V-Fib)

A continuous, uncoordinated, chaotic rhythm that does not produce pulses.

ventricular tachycardia (VT or V-Tach)

A rapid heart rhythm that might produce a pulse and is generally too fast to adequately perfuse the body's organs.

witnessed cardiac arrest

A cardiac arrest in which an EMT or other emergency responder witnesses the patient become unresponsive, apneic, and pulseless (does not refer to a lay-person witnessing the patient collapse).