Types of Shock

Ability Enhancement – Trauma Life Support

V.Parthasarathy
Faculty of AHS: Lecturer TCM
Dept of Emergency Medicine
 Overview

➢ Introduction
➢ Signs and symptoms
➢ Types
➢ Management
➢ Cardiac Arrest

16/03/2021
 Introduction
Perfusion : Delivery of oxygen and nutrients and removal of wastes from the cells, organs, and tissues by the
circulatory system.
Adequate circulation
• Pumping heart,
• Intact vascular system,
• Appropriate amount of oxygen-carrying blood.

Shock or hypoperfusion: Shock is an abnormal state associated with inadequate tissue perfusion, oxygen and
nutrient delivery to the metabolic needs of the cell
• Impairment of cellular metabolism
• Inadequate perfusion of vital Organs.
 Types of Shock

Types of Shock

Central shock Peripheral Shock

Distributive shock
-Anaphylactic
Cardiogenic shock Obstructive shock Hypovolemic shock
-Septic shock
-Neurogenic shock
 Central Shock
Cardiogenic shock - heart cannot circulate enough blood to maintain adequate peripheral oxygen delivery.

Causes:

• Myocardial infarction

• Arrythmias- Abnormal heart rhythm

• Heart failure- Right heart & Left heart

Obstructive Shock - occurs when blood flow becomes impeded or blocked in the heart or great vessels.

Causes:

• Pericardial Tamponade

• Tension pneumothorax

• Pulmonary embolism
 Peripheral Shock

Hypovolemic shock: Circulating blood volume is insufficient to deliver adequate oxygen and nutrients
to the body
➢ Due to Loss of blood and body fluids

Causes:
• Bleeding- internal or external
• Burns
• Vomiting
• Diarrhea
Distributive shock: Circulating blood volume then pools in the expanded vascular beds, and tissue
perfusion decreases due to wide spread vasodilation
• Anaphylaxis (Severe form of allergic reaction): Allergens, Insect bites, food materials- Histamine
• Septic shock occurs as a result of widespread infection, usually bacterial
• Neurogenic shock usually results from spinal cord injury
Causes:
• RTA
• Fall from height
• Penetrating injury to the cord
 Management

• Standard precaution- Gloves, mask, eye gear

• Scene safety
I. Airway with
– Cervical spine immobilization,
– Open-Jaw thrust, Clear-suctioning, maintain- OPA/NPA
II. Breathing-
– High flow oxygen with NRBM 15lt/min
– Assist ventilation with BVM if apneic
III. Circulation
– Bleeding Control by direct pressure method
– Two large bore IV access 14 G,16G or 18G
– IV fluids NS or RL (if hypovolemic)
IV. Anaphylactic shock – Injection adrenaline , IV fluid, bronchodilators
V. Tension pneumothorax- Needle decompression
VI. Pericardial tamponade- Pericardiocentesis
VII. Pulmonary embolism – Thrombolytics
VIII.Septic shock- Antibiotics, vasopressors
Thank You