Shock: Part 2

Types of Shock

1. Cardiogenic Shock

  • Definition: A primary heart problem where the heart struggles to pump effectively.

  • Causes:

    • Heart attack: the heart muscle is dying.

    • Congestive heart failure: one or both sides of the heart are failing.

  • Treatment Plan:

    • Provide oxygen to keep saturation above 84%.

    • Administer aspirin if the patient is awake.

    • Keep the patient warm and regularly reassess vitals.

    • Rapid transport to the hospital; notify the hospital early about the shock status.

2. Obstructive Shock

  • Definition: Blood flow is obstructed; it's not due to a pump failure in the heart itself.

  • Common Causes:

    • Tension pneumothorax: Air builds up in the pleural space, exerting pressure on the heart.

    • Pulmonary embolism: A clot obstructs blood flow in the pulmonary arteries.

    • Cardiac tamponade: Inflammation surrounding the heart, hindering its ability to pump.

  • Treatment Plan:

    • Provide oxygen.

    • For tension pneumothorax, consider a three-sided dressing.

    • If the patient isn't conscious, administer BVM ventilations.

3. Distributive Shock

  • Definition: A result of factors causing blood vessel dilation and reduced blood flow.

  • Subtypes:

    • Anaphylaxis: Severe allergic reaction.

    • Septic Shock: Resulting from sepsis, often due to pneumonia or UTI, leading to hypotension.

    • Neurogenic Shock: Caused by damage to the brain or spinal cord.

  • Treatment Plan:

    • Provide oxygen for all types.

    • Use an EpiPen for anaphylactic shock.

4. Hypovolemic Shock

  • Definition: A condition resulting from a significant loss of blood or fluids.

  • Common Causes:

    • External or internal trauma causing bleeding.

    • Severe dehydration.

  • Treatment Plan:

    • Control bleeding: apply direct pressure and consider hemostatic agents (like quick clot).

    • Provide oxygen, keep the patient warm, and prepare for rapid transport.

General Principles of Shock Care

  • Oxygen: All patients in shock should receive oxygen.

  • Keep Warm: Maintain the patient's body temperature.

  • Vitals Monitoring: Regularly check and assess vital signs.

  • Rapid Transport: Move the patient efficiently and inform the hospital of their status as early as possible.