SHOCK

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Shock is a loss of effective circulation (hypoperfusion) resulting in impaired tissue oxygen and nutrient delivery. Shock eventually causes life threatening organ failure. [ARC 2016]

Causes of SHOCK include:

●  Hypovolaemic: severe bleeding (internal and / or external), major or multiple fractures or major trauma, severe burns, severe diarrhoea/ vomiting/ sweating

●  Cardiogenic: heart attack, dysrhythmias

●  Distributive (abnormal vessel dilation): severe infection, allergic

reactions, spinal injuries

●  Obstructive (blockage of blood flow in/out of the heart): tension

pneumothorax, cardiac tamponade, pulmonary embolus, pregnancy (compression of large abdominal blood vessels by the uterus)

The CIRCULATORY SYSTEM can be thought of simply as a garden reticulation system

●  The function of the system is to keep the grass green!

●  Any disruption in the system will cause the other elements to react/compensate

●  If pressure can’t be maintained in the system, the result is SHOCK!

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Treatment:

Try not to think of treating someone for “shock” alone, Rather- try to identify and treat the contributing factors early

• This includes:

   

  1. Complete a thorough DRSABCDEFG assessment

  2. Stop bleeding and treat “fixable” problems immediately

  3. Prioritise environmental protection for the patient- sick people

     are unable to care for themselves!!

  4. Reassure and constantly re-check the patient’s condition for

     any changes

  5. For patients with no evidence of trauma the use of passive

     leg raise may provide a transient (< 7 minutes) improvement.

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Evacuation: Consider: All patients with injuries significant enough to cause uncontrolled shock Rapid: Deteriorating patients, uncontrollable bleeding, airway problems and unstable vital signs

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