NREMT EMT 6: Anatomy, Physiology, and Pathophysiology - Pathophysiology of Shock, Hypovolemic, Cardiogenic, Obstructive, Distributive, Septic, Neurogenic, Anaphylactic, Stages of Shock

What This Is: Shock

Shock is a life-threatening condition where the body's organs don't get enough blood flow. Imagine a car with a clogged gas line – the engine won't run, and the car won't move. In shock, the body's "engine" (organs) can't function properly because of a lack of blood flow.

Key Steps / Core Facts:

• Hypovolemic Shock: Low blood volume (like a water bottle with a hole in it). Causes: bleeding, dehydration, severe burns. (Mnemonic: Bleeding, Burns, Burns, Burns)
  • Causes: 30% blood loss or more
  • Signs: pale skin, weak pulse, low blood pressure
• Cardiogenic Shock: Heart can't pump blood effectively (like a clogged engine). Causes: heart attack, heart failure, severe infection. (Mnemonic: Heart Attack, Failure, Infection)
  • Causes: heart failure or severe heart damage
  • Signs: weak pulse, low blood pressure, shortness of breath
• Obstructive Shock: Something blocks blood flow (like a kinked hose). Causes: tension pneumothorax, massive pulmonary embolism. (Mnemonic: Tension Pneumothorax, Massive Pulmonary Embolism)
  • Causes: blockage of blood flow to the lungs or heart
  • Signs: difficulty breathing, chest pain, weak pulse
• Distributive Shock: Blood vessels are too wide or too narrow (like a balloon that's too big or too small). Causes: sepsis, anaphylaxis, neurogenic shock. (Mnemonic: Sepsis, Anaphylaxis, Neurogenic)
  • Causes: infection, allergic reaction, spinal cord injury
  • Signs: low blood pressure, rapid heart rate, cool skin
• Stages of Shock:
  • Compensatory Stage: Body tries to compensate for low blood flow (like a car's emergency brake). Lasts 30 minutes to 1 hour.
  • Decompensatory Stage: Body can't compensate, and organs start to fail (like a car's engine seizing). Lasts 1-2 hours.
• Assessment: Check vital signs, look for signs of shock, and assess the patient's level of consciousness. (Mnemonic: AVPU – Alert, Voice, Pain, Unresponsive)
• Treatment: Administer oxygen, fluids, and medications as needed. (Mnemonic: OPQRSTI – Onset, Pattern, Quality, Radiation, Severity, Time, Injury)

What Laypeople Can Do:

• If someone is in shock, call 911 or your local emergency number immediately.
• If the person is conscious, have them lie down and elevate their legs 12-18 inches.
• If the person is unconscious, start CPR if you're trained to do so.
• Keep the person calm and comfortable until help arrives.

Common Mistakes:

• Mistake: Not recognizing the signs of shock.
• Fix: Pay attention to changes in the patient's vital signs and level of consciousness.
• Mistake: Not calling for help immediately.
• Fix: Call 911 or your local emergency number as soon as possible.
• Mistake: Trying to treat shock with home remedies.
• Fix: Only administer medications and treatments as directed by a medical professional.

Quick Practice Scenarios:

1. A patient comes in with a severe head injury and is unresponsive. What should you do first?

Answer: Call 911 or your local emergency number immediately. Reason: Get medical help as soon as possible.

1. A patient is experiencing severe chest pain and difficulty breathing. What should you do first?

Answer: Call 911 or your local emergency number immediately. Reason: Get medical help as soon as possible.

1. A patient is in shock and is conscious. What should you do first?

Answer: Have them lie down and elevate their legs 12-18 inches. Reason: Help increase blood flow to the brain and other vital organs.

Last-Minute Exam Cram:

• Normal blood pressure: 90-120/60-80 mmHg
• Normal heart rate: 60-100 beats per minute
• Normal respiratory rate: 12-20 breaths per minute
• Normal body temperature: 97.7-99.5°F (36.5-37.5°C)
• CPR compression depth: at least 2 inches
• CPR compression rate: 100-120 compressions per minute
• Agonal breathing is NOT normal breathing – start CPR
• Hypovolemic shock can be caused by bleeding, dehydration, or severe burns
• Cardiogenic shock can be caused by heart attack, heart failure, or severe infection
• Obstructive shock can be caused by tension pneumothorax or massive pulmonary embolism
• Distributive shock can be caused by sepsis, anaphylaxis, or neurogenic shock