SHOCK

REPORTED BY:
IVAN PAUL A. CANDO
SHOCK
Shock is a life threatening situation due to
poor tissue perfusion with impaired cellular
metabolism, manifested in turn by serious
Patho-physiological abnormalities.
(Bailey and love)
SHOCK
Shock is a term used to describe the clinical

syndrome that develops when there is critical
impairment of tissue perfusion due to some form
of acute circulatory failure. (Davidson’s)

 Shock may be defined as inadequate delivery of

oxygen and nutrients to maintain normal
tissue and cellular function.(Schwartz’s)
CARDIOGENIC SHOCK
Cardiogenic shock can be caused by any disease, or
event, which prevents the heart muscle from
pumping strongly and consistently enough to
circulate the blood normally. Heart attack, conditions
which cause inflammation of the heart muscle
(myocarditis), disturbances of the electrical rhythm of
the heart, any kind of mass or fluid accumulation
and/or blood clot which interferes with flow out of
the heart can all significantly affect the heart's ability
to adequately pump a normal quantity of blood.
HYPOVOLEMIC SHOCK
Hypovolemic shock occurs when the total volume of
blood in the body falls well below normal. This can
occur when there is excess fluid loss, as in
dehydration due to severe vomiting or diarrhea,
diseases which cause excess urination (diabetes
insipidus, diabetes mellitus, and kidney failure),
extensive burns, blockage in the intestine,
inflammation of the pancreas (pancreatitis), or severe
bleeding of any kind.
SEPTIC SHOCK
Septic shock can occur when an untreated or
inadequately treated infection (usually bacterial) is
allowed to progress. Bacteria often produce
poisonous chemicals (toxins) which can cause injury
throughout the body. When large quantities of these
bacteria, and their toxins, begin circulating in the
bloodstream, every organ and tissue in the body is at
risk of their damaging effects.
 SEPTIC SHOCK
The most damaging consequences of these bacteria and
toxins include poor functioning of the heart muscle;
widening of the diameter of the blood vessels; a drop
in blood pressure; activation of the blood clotting
system, causing blood clots, followed by a risk of
uncontrollable bleeding; damage to the lungs, causing
acute respiratory distress syndrome; liver failure;
kidney failure; and coma.
DEHYDRATION
Dehydration takes place when your body loses more
fluid than you drink. The most common cause of
water loss from the body is excessive sweating.
SIGNS
•Cool, clammy skin
•Pale or ashen skin
•Rapid pulse
•Rapid breathing
•Nausea or vomiting
•Enlarged pupils
•Weakness or fatigue
•Dizziness or fainting
•Changes in mental status or behavior, such as
anxiousness or agitation
STAGES OF SHOCK
 NON-PROGRESSIVE (INITIAL, REVERSIBLE)
SHOCK
 PROGRESSIVE DECOMPENSATED SHOCK

 DECOMPENSATED (IRREVERSIBLE) SHOCK

 NON-PROGRESSIVE SHOCK
In Stage I of shock, when low blood flow (perfusion) is
first detected, a number of systems are activated in
order to maintain/restore perfusion. The result is
that the heart beats faster, the blood vessels
throughout the body become slightly smaller in
diameter, and the kidney works to retain fluid in the
circulatory system. All this serves to maximize blood
flow to the most important organs and systems in the
body. The patient in this stage of shock has very few
symptoms, and aggressive treatment may slow
progression.
 DECOMPENSATED OR
PROGRESSIVE
In Stage II of shock, these methods of compensation
begin to fail. The systems of the body are unable to
improve perfusion any longer, and the patient's
symptoms reflect that fact. Oxygen deprivation in the
brain causes the patient to become confused and
disoriented
 IRREVERSIBLE STAGE
In Stage III of shock, the length of time that poor
perfusion has existed begins to take a permanent toll
on the body's organs and tissues. The heart's
functioning continues to spiral downward, and the
kidneys usually shut down completely. Cells in organs
and tissues throughout the body are injured and
dying. The endpoint of Stage III shock is patient
death.
 FIRST AID OF SHOCK
Call 911
1. Lay the Person Down, if Possible

Elevate the person's feet about 12 inches unless head,

neck, or back is injured or you suspect broken hip or
leg bones.
 Do not raise the person's head.

 Turn the person on side if he or she is vomiting or

bleeding from the mouth.
 FIRST AID OF SHOCK
2. Begin CPR, if Necessary

If the person is not breathing or breathing seems

dangerously weak:
 For a child, start CPR for children.

 For an adult, start adult CPR.

 Continue CPR until help arrives or the person wakes

up.
FIRST AID OF SHOCK

3. Treat Obvious Injuries

 FIRST AID OF SHOCK
4. Keep Person Warm and Comfortable

 Loosen restrictive clothing.

 Cover with coat or blanket.

 Keep the person still. Do not move the person unless

there is danger.
 Reassure the person.

 Do not give anything to eat or drink.

 FIRST AID OF SHOCK
5. Follow Up

 At the hospital, the person will be given oxygen and

intravenous fluids.
 Blood test, urine tests, heart test and xrays and/or
CT scans may be done.
 Other treatment will depend on the cause of shock.
 CARDIO PULMONARY
RESUSCITATION
Before Giving CPR
1.
Check the scene and the person. Make sure
the scene is safe, then tap the person on the
shoulder and shout "Are you OK?" to ensure
that the person needs help.
 CARDIO PULMONARY
RESUSCITATION
2
Call 911 for assistance. If it's evident that the
person needs help, call (or ask a bystander to
call) 911, then send someone to get an AED.
(If an AED is unavailable, or a there is no
bystander to access it, stay with the victim, call
911 and begin administering assistance.)
 CARDIO PULMONARY
RESUSCITATION
3
Open the airway. With the person lying on his
or her back, tilt the head back slightly to lift
the chin.
 CARDIO PULMONARY
RESUSCITATION
4.
Check for breathing. Listen carefully, for no
more than 10 seconds, for sounds of breathing.
(Occasional gasping sounds do not equate to
breathing.) If there is no breathing begin CPR.
 RED CROSS CPR STEPS

1.
Push hard, push fast. Place your hands, one on
top of the other, in the middle of the chest.
Use your body weight to help you administer
compressions that are at least 2 inches deep
and delivered at a rate of at least 100
compressions per minute.
 RED CROSS CPR STEPS

2.
Deliver rescue breaths. With the person's head
tilted back slightly and the chin lifted, pinch
the nose shut and place your mouth over the
person's mouth to make a complete seal. Blow
into the person's mouth to make the chest rise.
Deliver two rescue breaths, then continue
compressions.
 RED CROSS CPR STEPS

Note: If the chest does not rise with the initial

rescue breath, re-tilt the head before delivering
the second breath. If the chest doesn't rise with
the second breath, the person may be choking.
After each subsequent set of 30 chest
compressions, and before attempting breaths,
look for an object and, if seen, remove it.
 RED CROSS CPR STEPS

3
Continue CPR steps. Keep performing cycles
of chest compressions and breathing until the
person exhibits signs of life, such as breathing,
an AED becomes available, or EMS or a
trained medical responder arrives on scene.
 RED CROSS CPR STEPS

Note: End the cycles if the scene becomes

unsafe or you cannot continue performing
CPR due to exhaustion
FIRST AID OF SHOCK
FIRST AID OF SHOCK