Shock 2023-2022 PDF

Shock Shock  Introduction:  Shock is a serious condition results form  a failure of any one of the three aspects of circulation:  The heart pump, peripheral resistance; and blood volume.  The medical definition of shock is ‘inadequate tissue perfusion, caused by a fall in bloo...

Shock Shock  Introduction:  Shock is a serious condition results form  a failure of any one of the three aspects of circulation:  The heart pump, peripheral resistance; and blood volume.  The medical definition of shock is ‘inadequate tissue perfusion, caused by a fall in blood pressure and blood volume’.  This means there is an inadequate supply of oxygenated blood to the tissues of the body. Definition  Shock is a life threatening condition it happens when the body isn’t getting enough blood and oxygen to the vital organs; may be caused by hemorrhage, infection, trauma; cardiac disease and allergic.  Type of the shock:  There are three main types of shock:  hypovolaemic  Cardiogenic  and distributive shock which classified into septic shock, anaphylactic shock, and neurogenic shock.  The most common causes of life threatening shock are:  Hypovolaemic Shock.  Cardiogenic Shock.  Anaphylactic Shock. Hypovolaemic Shock:  Hypovolaemic shock (Hypo = low; vol = volume; aemic = blood) is caused by loss of bodily fluids, the result of which is low blood volume.  Hypovolaemic shock is usually caused by:  External bleeding.  Internal bleeding.  Burns.  Vomiting and diarrhoea.  Excessive sweating.  Signs and symptoms:  Usually the first response is a release of adrenaline which will cause:  Pulse rate to rise.  Pale, clammy skin. For dark skinned casualties check the color of the skin inside the lips  As the condition deteriorates:  Shallow, fast breathing.  Nausea or vomiting.  Weak, rapid pulse.  Dizziness or weakness.  Cyanosis (grey/blue tinge to lips and skin). Sweating  As the brain receives less oxygen:  Deep breathing (air hunger).  Anxiety, confusion, possible aggression.  Unconsciousness. .  First aid to Hypovolaemic Shock:  1-Try to treat the cause of the shock (e.g. external bleeding).  2-Lay the casualty on a flat surface (preferably the floor) and raise their legs so they are above the chest (heart). This will cause the blood to return to the vital organs as 40% of the body’s blood is in the legs. Take care if you suspect a fracture.  3-Dial 123 for an ambulance immediately.  4-Keep the casualty warm – place a blanket or coat under the casualty if they are on the floor or other cold surface. However, be careful not to overheat them as this dilates the blood vessels which will cause their blood pressure to drop further.  5-Do not allow the casualty to drink, eat or smoke.  6-Loosen any tight clothing such as ties and belts.  7-Monitor the casualty’s breathing, pulse and response levels.  8-Be prepared to perform CPR.  Cardiogenic Shock:  This form of shock occurs when there is a fall in blood pressure caused by the heart not pumping properly. This is the most common type of shock.  Typical causes of cardiogenic shock are:  Heart attack (myocardial infarction).  Tension pneumothorax.  Cardiac failure.  Cardiac arrest.  Heart valve disease.  Signs, symptoms of cardiogenic shock  Rapid breathing  Severe shortness of breath  Sudden, rapid heartbeat (tachycardia)  Loss of consciousness  Weak pulse  Low blood pressure (hypotension)  Sweating  Pale skin  Cold hands or feet  Urinating less than normal or not at all  First aid to cardiogenic shock:  Sit the casualty down and make them comfortable.  Try to stop them from walking around or doing anything strenuous.  Sit them in the Fowler position. Have them lean against a wall, or your knees if no other option, and raise their knees.  Ask the casualty if they have any medication with him.  take their medication.  DO NOT GIVE IT TO him DIRECTLY HELP him SELF MEDICATE.  1-Reassure the casualty. Remove any causes of stress or anxiety if possible.  2-If you have any reason to suspect a heart attack – check if the casualty is allergic to aspirin, older than 16 or if they are taking any ‘anti- coagulant’ drugs , allow them to chew an aspirin tablet slowly, as this may be beneficial. If, however, you are unsure of any of the above, wait for the ambulance to arrive.  3-Monitor the casualty. If it is a heart attack and the casualty becomes unconscious it is more than likely the heart has stopped and you will need to perform CPR, so be prepared.  Aspirin helps stop clotting in the blood. Having a casualty chew an aspirin tablet allows the drug to be absorbed into the blood stream through the skin of the mouth, helping it work faster. The ideal dose of aspirin is 300mg, but any strength will do in these cases.  Dial 123 for an ambulance if:  You have any reason to suspect it is a heart attack.  The casualty has no history of angina.  The symptoms suffered are different or worse than the casualty’s usual angina attacks.  The pain from an angina attack is not relieved by the casualty’s medication and rest after 15 minutes.  Anaphylactic Shock:  Anaphylaxis is an extremely dangerous allergic reaction which occurs by a massive over-reaction of the body’s immune system.  Severe anaphylactic reaction is a rare occurrence, usually caused by drugs such as penicillin, insect stings, nuts and dairy produce.  An anaphylactic reaction may result in shock due to a large quantity of histamine. This can result in:  Constricts the bronchioles in lungs.  Makes the skin itchy and come out in a rash.  Blood vessels dilating which causes blood pressure to fall.  Blood capillary walls may become ‘leaky’ causing blood volume to fall.  Weakening of the heart’s contraction which causes blood pressure to fall.  Signs, symptoms of anaphylactic shock:  An allergic reaction can occur in seconds, so recognizing the problem is essential:  Casualty’s face, tongue, neck, lips and eyes may suddenly swell up.  Their voice may become hoarse, developing a ‘lump in the throat’ which may lead to loud, noisy breathing which may stop altogether.  Tightness in the chest, difficulty breathing, wheezing (the casualty may have the equivalent of an asthma attack, with the addition of a swollen airway).  Weak, rapid pulse.  Nausea, stomach cramps, vomiting, diarrhea.  Itchy, red or blotchy skin.  Anxiety, a feeling of impending doom.  First aid to anaphylactic shock:  1-Dial 123 for an ambulance immediately.  2-Lay the casualty in as comfortable position as possible. If the casualty is having problems breathing, they may want to sit up to ease this.  3-If the casualty is feeling faint, do not let them sit up. Keep them lying flat and raise their legs.  4-If the casualty is aware of their condition, they may be carrying an adrenaline shot (epinephrine). This can save the casualty’s life if administered.  5-The casualty can usually give themselves the adrenaline shot (epinephrine), but if they are unable you may have to help them.  6-If the casualty becomes unconscious, check their airway and breathing and resuscitate, as necessary.  7-The adrenaline shot (epinephrine) can be given again if there is no improvement, or symptoms return after five minutes. Poisoning  Definition of poison:  Poisons can be defined as a liquid, solid or gaseous substance that causes damage to the body when it enters in sufficient quantity.   There are 4 ways a poison can enter the body:  1-Ingested The substance is swallowed, either by accident or on purpose.  2-Inhaled The substance is breathed in, entering the blood stream very quickly through the alveoli.  3-Absorbed The substance comes in contact with skin  4-Injected The substance is introduced through the skin directly into tissue or a blood vessels  A poison can be one of two things:  1-Corrosive These include acids, bleach, petrol, ammonia, dishwasher powder.  2-Non-Corrosive These include tablets, plants, drugs, perfume, alcohol, etc.  Signs and symptoms:  There are a wide variety of signs and symptoms for poisoning, depending on the substance. Some clues you can look for are:  Bottles or containers.  Tablets or drugs.  Syringes or drug taking.  Smell on the casualty’s breath.  Some other signs that can accompany poisoning may be:  Nausea, retching or vomiting.  Abdominal pain.  Burns (or a burning sensation) around the area of entry.  Problems breathing.  Hallucinations or confusion.  Headache.  Unconscious. Sometimes the casualty may start fitting.  Cyanosis.  Treatment for poisoning:  A)For a corrosive substance:  -firstly, make sure that your safety is secure– Is it safe to help the casualty?  -Dilute or wash away the substance if possible:  -Substance on the skin – If the chemical is a dry powder, it can be brushed off the casualty’s skin before treatment.  -Ingested substances – try to get the casualty to rinse their mouth, then give frequent sips of milk or cold water.  -Dial for an ambulance immediately: Give clear and concise information about the poison if possible. Follow any advice given by the ambulance operator.  -If the casualty becomes unconscious, immediately open the airway and check for breathing. If they are not breathing commence CPR using a protective face shield. -If the casualty is breathing but unconscious, place them in the recovery position and dial for an ambulance immediately.  -Never try to get the casualty to vomit as this may damage the airway.  B)For non-corrosive substances:  -Dial for an ambulance immediately: Give clear and concise information about the poison if possible. Follow any advice given by the ambulance operator.  -If the casualty becomes unconscious, immediately open the airway and check for breathing.  If they are not breathing commence CPR using a protective --face shield.  If the casualty is breathing but unconscious, place them in the recovery position and dial for an ambulance immediately.  It will be of help to the paramedics if you:  Pass on the container the substance was in, or pass on any information you may have regarding what the casualty has taken.  Let them know how much was taken, if you are able to ascertain this information.  Let them know when the substance was taken, if you can ascertain this information.  Keep any sample of vomit from the casualty for hospital analysis.