Their are five types of shock: cardiogenic, hypovolemic, neurogenic, anaphylactic, and septic. We will break down each type of shock and provide greater detail.
Inability of the heart to pump enough blood throughout the body. This is a result of left ventricular failure (caused by an MI or CHF). Due to the reduced BP caused by cardiogenic shock, the heart muscle becomes more damaged due to the lack of coronary artery perfusion...this can eventually lead to complete pump failure. Cardiac output, as well as the cardiac ejection fraction, is also decreased.
During the assessment, rales or rhonchi will be heard in the lungs, and white- or pink-tinged foamy sputum may be present.
Ensure that the airway is open and patent. ADM oxygen and assist ventilation if needed. Keep the patient warm since their body may no longer be able to keep them warm and organs functioning. Obtain IV access, cardiac monitoring, and 12-lead ECG.
Patient goes into shock due to a loss of intravascular fluid volume caused by: internal/external bleeding, traumatic injury, long bone or open fractures, dehydration, diarrhea, vomiting, plasma loss from burns, excessive sweating, and DKA.
During assessment, the patient may alerted, unresponsive, pale, cool, diaphoretic, normal to hypotensive, pulse normal to rapid (bradycardia in late stage), decrease in urine output, cardiac dysrhythmias.
Ensure that the airway is open and patent. ADM oxygen and assist ventilation if needed. Keep the patient warm since their body may no longer be able to keep them warm and organs functioning. Control and major bleeding. Obtain IV access, fluid bolus (NS or LR), cardiac monitoring, and 12-lead ECG.
Results from an injury to the brain or spinal cord, which results in an interruption of the nerve impulses to the arteries. The arteries will lose tone and dilate, causing hypovolemia; no change in volume, just that the container is now larger.
Assessment may reveal warm, red skin, and dry skin (due to malfunction of the sweat glands). Hypotension and bradycardia.
Ensure that the airway is open and patent. ADM oxygen and assist ventilation if needed. Keep the patient warm since their body may no longer be able to keep them warm and organs functioning. Spinal immobilization, obtain IV access, fluid bolus (NS), cardiac monitoring, and 12-lead ECG.
Cushing Triage: Hypertension, Bradycardia, Irregular Respirations
When an allergen enters in the body, the immune system respond to try to rid of that allergen. However, in some cases, the immune response is so great, that it is called anaphylactic.
Assess for dyspnea, tachypenia, wheezing, laryngeal edema, rashes, edema, hives, cyanosis, tachycardia, seizures, altered LOC.
Patient's in anaphylactic shock needed immediate and aggressive treatment. Ensure open and patent airway. ADM oxygen. Epi 1:1000 should be adm IM. Benadryl to help prevent any more histamine to be released int he body, Solu-medrol for steroid response, albuterol for the bronchioconstriction.
When an infection enters into the body, causes a system wide failure or dysfunction of the organs.
During assessment look for, fever, tachycardia, hypotension, tachypnea, altered LOC.
Ensure an open and patent airway. ADM oxygen. IV access with fluid bolus of NS. ECG monitoring and 12-lead ECG. Dopamine may need to be adm in order to maintain a blood pressure.
In the elderly and very young, a fever may not be present. Try to identify if the patient had a fever or if they are hypothermic...both are indicative of sepsis when combined with the other criteria listed above.
Information obtained from: Essentials of Paramedic Care. Second Edition - UPDATE.