Ohio Department of Public Safety Division of EMS

Trauma Education Module Shock

August 2003

Shock

Shock OBJECTIVES
Shock and Fluid Resuscitation List the signs and symptoms of each type of shock. List the indications for intravenous fluid replacement. Identify the need for rapid transport when confronted with continuing hypoperfusion.

Shock
List the signs and symptoms of hemorrhagic shock
Signs & Symptoms
Skin Respirations Blood Pressure Pulse Capillary Refill Level of Consciousness

Shock
List the signs and symptoms of hemorrhagic shock
Blood Loss Up to 750 ml Blood Loss 750-1500 ml Blood Loss Blood Loss 1500- 2000 ml > 2000 ml

Pulse Rate

< 100

>100

>120

>140

Blood Pressure
Pulse Pressure

Normal

Normal

Decreased Decreased

Normal or Decreased Decreased Decreased Increased

Respiratory Rate
CNS/Mental Status

14-20
Slightly anxious

20-30
Mildly anxious

30-40
Anxious, confused

> 35
Confused, lethargic

Shock
List the signs and symptoms of non-hemorrhagic shock
Signs & Symptoms - Neurogenic Shock Skin Respirations Blood Pressure Pulse Capillary Refill Level of Consciousness

Shock
List the signs and symptoms of obstructive shock
Signs & Symptoms Tension Pneumothorax, Pericardial Tamponade Skin Respirations Blood Pressure Pulse Capillary Refill Level of Consciousness

Shock
List the indications for intravenous fluid replacement
Volume Replacement

Medication Administration

Shock
Identify the need for rapid transport when confronted with continuing hypoperfusion

Transportation

Shock Triage Concerns

TRANSPORT TO A TRAUMA CENTER IF Pulse greater than one hundred twenty in combination with evidence of hemorrhagic shock; Systolic blood pressure less than ninety, or absent radial pulse with carotid pulse present; Evidence of hemorrhagic shock means physiologic indicators of blood loss that may include any of the following symptoms:
Delayed capillary refill; Cool, pale, diaphoretic skin; Decreased systolic blood pressure with narrowing pulse pressure; Altered level of consciousness.

TRAUMA CENTER

Shock Special Pediatric Triage Concerns

TRANSPORT TO A TRAUMA CENTER IF Evidence of poor perfusion means physiologic indicators of hemorrhage or decreased cardiovascular function, which may include any of the following symptoms: Weak distal pulse; Pallor; Cyanosis; Delayed capillary refill; Tachycardia.

PEDIATRICT RAUMA CENTER

Shock Summary
Shock

Shock

Case Study

Shock QUESTIONS ?

References & Resources

PHTLS Basic & Advanced Prehospital Trauma Life Support, 4th Edition Mosby
Basic Trauma Life Support, 4th Edition, Brady

BTLS ATLS
Advanced Trauma Life Support, 6th Edition, American College of Surgeons