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.