EMT ch 13

What is required for adequate perfusion?

An intact cardiovascular system and a functioning respiratory system.

What are the three parts of the perfusion triangle?

The pump (heart), the pipes (blood vessels), and the content (blood volume).

What is shock (hypoperfusion)?

Collapse and failure of the cardiovascular system in which blood circulation slows and eventually stops.

What is the function of blood?

To carry oxygen and nutrients to tissues and remove waste products.

What are the components of blood?

Red blood cells, white blood cells, platelets, and plasma.

What is systolic blood pressure?

The peak arterial pressure generated when the heart contracts.

What is diastolic blood pressure?

The pressure maintained in the arteries while the heart rests between beats.

What are the major types of shock?

Cardiogenic, obstructive, septic, neurogenic, anaphylactic, psychogenic, and hypovolemic.

What are the signs of compensated shock?

Anxiety/agitation, tachycardia, pale cool moist skin, increased respiratory rate, nausea/vomiting, increased thirst.

What are the signs of decompensated shock?

Labored or irregular respirations, ashen gray or cyanotic skin, weak/absent distal pulses, dilated pupils, profound hypotension (SBP ≤90 mmHg in adults).

When is shock usually advanced?

By the time a decrease in blood pressure is detected.

What conditions should make you anticipate shock?

Severe infection, major blunt/penetrating trauma, massive bleeding or suspected internal bleeding, spinal cord injury, chest/abdominal injury, major heart attack, anaphylaxis.

How is pediatric or geriatric shock treated?

The same way as any other shock patient.

What is the first priority in treating shock?

Open and maintain the airway.

What is the second priority in treating shock?

Control life-threatening hemorrhage with direct pressure or a tourniquet if appropriate.

What oxygen treatment is given to shock patients?

Provide high-flow oxygen and assist ventilations with a bag-mask device if needed.

How should body temperature be managed in shock?

Maintain normal body temperature with blankets.

How should shock patients be emotionally managed?

Provide calm reassurance.

What is the final treatment priority for shock?

Prompt transport to the appropriate hospital.

Afterload

The force or resistance against which the heart pumps.

Anaphylactic shock

Severe shock caused by an allergic reaction.

Anaphylaxis

An extreme, life-threatening systemic allergic reaction that may include shock and respiratory failure.

Aneurysm

A swelling or enlargement of an artery caused by weakening of the arterial wall.

Autonomic nervous system

The part of the nervous system that regulates involuntary functions such as heart rate, blood pressure, and digestion.

Cardiac tamponade

Compression of the heart caused by blood or fluid in the pericardial sac, decreasing cardiac output.

Cardiogenic shock

A type of shock caused by inadequate cardiac output, resulting in insufficient oxygen delivery to tissues.

Compensated shock

Early stage of shock in which the body maintains blood pressure through compensation.

Cyanosis

Bluish skin discoloration caused by reduced oxygen in the blood.

Decompensated shock

Late stage of shock in which blood pressure falls because compensation fails.

Dehydration

Loss of water from body tissues.

Distributive shock

Shock caused by widespread dilation of small arteries and veins.

Edema

Abnormal accumulation of fluid in body tissues causing swelling.

Homeostasis

The body's ability to maintain internal balance.

Hypothermia

Internal body temperature below 95°F (35°C).

Hypovolemic shock

Shock caused by low blood volume due to bleeding or fluid loss.

Irreversible shock

Shock in which resuscitation is no longer possible despite treatment.

Myocardial contractility

The ability of the heart muscle to contract.

Neurogenic shock

Shock caused by loss of nervous system control of blood vessel tone, resulting in widespread vasodilation.

Obstructive shock

Shock caused by blockage of blood flow in the heart or great vessels.

Perfusion

The flow of blood through body tissues and vessels.

Pericardial effusion

Fluid accumulation between the pericardial sac and the myocardium.

Preload

The precontraction pressure in the heart as blood fills the ventricles.

Psychogenic shock

A temporary reduction in blood flow to the brain causing fainting (syncope).

Pulmonary embolism

A blood clot that travels to the lungs and obstructs blood flow.

Pulse pressure

The difference between systolic and diastolic blood pressure.

Sensitization

The process of developing sensitivity to a substance after an initial exposure.

Septic shock

Shock caused by severe infection, usually bacterial.

Shock

A condition in which the circulatory system fails to provide adequate circulation to maintain normal cellular function; also called hypoperfusion.

Sphincters

Ring-like muscles that constrict a duct, tube, or opening.

Syncope

A temporary loss of consciousness (fainting).

What are the three components of the perfusion triangle?

Heart (pump), blood vessels (pipes), blood (content).

Which type of shock is caused by severe blood or fluid loss?

Hypovolemic shock.

Which type of shock results from poor heart pumping ability?

Cardiogenic shock.

Which type of shock results from an allergic reaction?

Anaphylactic shock.

Which type of shock is caused by widespread infection?

Septic shock.

Which type of shock is caused by spinal cord injury?

Neurogenic shock.

Which type of shock results from a blockage of blood flow?

Obstructive shock.

Which type of shock causes fainting due to temporary decreased blood flow to the brain?

Psychogenic shock.

What skin findings suggest compensated shock?

Pale, cool, moist skin.

What skin findings suggest decompensated shock?

Ashen gray or cyanotic skin.

What pulse finding suggests decompensated shock?

Weak or absent distal pulses.

What pupil finding suggests decompensated shock?

Dilated pupils.

What blood pressure indicates profound hypotension in an adult?

Systolic blood pressure of 90 mmHg or lower.

What is the most important concept about blood pressure in shock?

A drop in blood pressure is a late sign of shock.