Central Mindanao University

College of Nursing
Cardiogenic
Shock
Hypovolemic
Shock
Neurogenic Shock Septic Shock Anaphylactic
Shock
Defniti
on
Cardiogenic
shock is the
failure of your
heart to pump
enough blood
to your major
organs to
support life.
Any process
that interferes
with the
pumping
action of your
heart or that
causes severe
injury to your
heart can
cause shock.
Failure of your
heart to pump
enough blood
to your major
organs causes
them to stop
working. his is
a medical
emergency!
and this
"ypovolemic
shock refers to a
medical or
surgical
condition in
which rapid #uid
loss results in
multiple organ
failure due to
inade$uate
circulating
volume and
subse$uent
inade$uate
perfusion. Most
often!
hypovolemic
shock is
secondary to
rapid blood loss
%hemorrhagic
shock&.
Neurogenic shock
result of
imbalance
between
parasympathetic
and symathemic
stimulation of
vascular smooth
muscle. 'f
parasympathetic
over stimulation
or sympathetic
under stimulation
persist sustained
vasodilation
occurs and blood
pools in the
venous or
capillary.
(eptic shock is
what happens as
a complication of
an infection
where to)ins can
initiate a full*
body
in#ammatory
response. 't often
occurs in people
who are elderly
or have a
weakened
immune system.
't is thought that
the in#ammation
resulting from
sepsis causes
tiny blood clots
to form! which
can block o)ygen
and nutrients
from reaching
vital organs. As a
result! the organs
fail! causing a
profound septic
shock. his may
Anaphyla)is is a
severe!
potentially life*
threatening
allergic reaction.
he #ood of
chemicals
released by your
immune system
during
anaphyla)is can
cause you to go
into shock+ your
blood pressure
drops suddenly
and your airways
narrow! blocking
normal
breathing.
(heen ,ose -. .irtudes /(N'.
0mergency 1isaster Nursing
Central Mindanao University
College of Nursing
condition can
cause death
$uickly
cause a drop in
blood pressure
and may result in
death.
Sings
and
Sympto
ms
Chest pain or
pressure
Coma
1ecreased
urination
Fast breathing
Fast pulse
"eavy
sweating!
moist skin
2ightheadedn
ess
2oss of
alertness and
ability to
concentrate
,estlessness!
agitation!
confusion
(hortness of
breath
(kin that feels
cool to the
touch
An)iety or
agitation
Cool! clammy
skin
Confusion
1ecreased or no
urine output
-eneral
weakness
3ale skin color
%pallor&
,apid breathing
(weating! moist
skin
"ypotension
/radycardia
"ypothermia
A rapid and deep
shallow breathing
1i4culty breathing
Cold and clammy
skin
3ale skin
appearance
Nausea and
vomiting
1i55iness and
lightheadedness
Fainting
,apid and weak
pulse
6eakness is
e)perienced as a
result of
insu4ciency in the
blood supply
/lank stares or the
eyes staring at
(ymptoms of septic
shock re$uire that
only one of the
following signs be
present7
Cool! pale
arms and legs
"igh or very
low
temperature!
chills
2ight*
headedness
2ittle or no
urine
2ow blood
pressure!
especially when
standing
3alpitations
,apid heart
rate
,estlessness!
agitation!
lethargy! or
abdominal pain
Abnormal %high*
pitched& breathing
sounds
An)iety
Chest discomfort or
tightness
Cough
1iarrhea
1i4culty breathing
1i4culty
swallowing
1i55iness or light*
headedness
"ives! itchiness
Nasal congestion
Nausea or vomiting
3alpitations
(kin redness
(lurred speech
(welling of the
face! eyes! or
tongue
(heen ,ose -. .irtudes /(N'.
0mergency 1isaster Nursing
Central Mindanao University
College of Nursing
3ale skin color
or blotchy skin
%thready&
pulse
nothing
An)iety
Change in mental
state or confusion
and disorientation
Unresponsive to
stimuli
/luish
discoloration of the
lips and 8ngers
which signify a
deprivation of
o)ygen in the body
2ow urine output
or urine may cease
0)cessive
sweating
(igni8cant chest
pain
Unconsciousness
confusion
(hortness of
breath
(kin rash or
discoloration
Unconsciousness
6hee5ing
Drugs/
Medicat
ion
1obutamine
1opamine
0pinephrine
2evosimendan
Milrinone
Norepinephrine
dopamine
dobutamine!
epinephrine!
and norepinephrin
e
/eta adrenergic
blocker
Alpha adrenergic
blocker
intravenous
antibiotics to
8ght infection
vaso pressure
medications 9
drugs that
constrict blood
vessels and help
0pinephrine
%adrenaline&
A beta*agonist
%such as albuterol&
"ydrocortisone
Chlorphenamine
(heen ,ose -. .irtudes /(N'.
0mergency 1isaster Nursing
Central Mindanao University
College of Nursing
increase blood
pressure
insulin for
blood sugar
stability
corticosteroid
s to help with
in#ammation
Phenylephrine
Ticarcillin
clavulanate
!Timentin"
Piperacillin
ta#o$actam
!%osyn"
&mipenem
cilastatin
!Prima'in"
Meropenem
!Merrem"
Clindamycin
!Cleocin"
Metronida#ole
!(lagyl"
Ce)tria'one
!*ocephin"
Cipro+o'acin
!Cipro"
Ce)epime
(heen ,ose -. .irtudes /(N'.
0mergency 1isaster Nursing
Central Mindanao University
College of Nursing
!Ma'ipime"
,evo+o'acin
!,eva-uin"
.ancomycin
Hydrocortison
e !A
Hydrocort/
SoluCorte)"
De'amethason
e
Treatme
nt/
Procedu
re
Cardiac
catheteri5atio
n with
coronary angi
oplasty and st
enting
"eart
monitoring to
guide
treatment
"eart surgery
%coronary
artery bypass
surgery! heart
valve
replacement!
left ventricular
:eep the person
comfortable and
warm %to
avoid hypotherm
ia&.
"ave the person
lie #at with the
feet lifted about
;< inches to
increase
circulation.
"owever! if the
person has a
head! neck!
back! or leg
injury! do not
change the
Fluid is always the
initial treatment of
shock! especially
since concomitant
hemorrhagic
shock must be
e)cluded following
trauma. Most
institutions will
additionally
utili5e pressor age
nts to
achieve hemodyna
mic stability.
1opamine %'ntropi
n& is often used
either alone or in
/reathing
machine
%mechanical
ventilation&
1ialysis
1rugs to treat
low blood
pressure!
infection! or
blood clotting
Fluids given
directly into a
vein
%intravenously&
=)ygen
(edatives
(urgery
Calm and reassure
the person.
'f the allergic
reaction is from a
bee sting! scrape
the stinger o> the
skin with something
8rm %such as a
8ngernail or plastic
credit card&. 1o not
use twee5ers **
s$uee5ing the
stinger will release
more venom.
'f the person has
emergency allergy
medicine on hand!
(heen ,ose -. .irtudes /(N'.
0mergency 1isaster Nursing
Central Mindanao University
College of Nursing
assist device&
'ntra*aortic
balloon
counterpulsati
on %'A/3& to
help the heart
work better
3acemaker
.entricular
assist device
or other
mechanical
support
3ain medicine
=)ygen
Fluids! blood!
and blood
products
through a vein
%'.&
person?s position
unless he or she
is in immediate
danger.
1o not give
#uids by mouth.
'f person is
having
an allergic
reaction! treat
the allergic
reaction! if you
know how.
'f the person
must be carried!
try to keep him
or her #at! with
the head down
and feet lifted.
(tabili5e the
head and neck
before moving a
person with a
suspected spinal
injury.
combination with
other inotropic age
nts.
.asopressin %antidi
uretic hormone
@A1"A&
Certain vasopresso
rs %ephedrine! nore
pinephrine&. 3heny
lephrine may be
used as a 8rst line
treatment! or
secondarily in
patients who do
not respond
ade$uately to
dopamine.
Atropine %administer
if bradycardia is
severe.&
help the person
take or inject the
medication. Avoid
oral medication if
the person is
having di4culty
breathing.
ake steps to
prevent shock.
"ave the person lie
#at! raise the
person?s feet about
;< inches! and
cover him or her
with a coat or
blanket. 1o N=
place the person in
this position if a
head! neck! back!
or leg injury is
suspected! or if it
causes discomfort.
endotracheal
intubation
tracheostomy or
cricothyrotomy
(heen ,ose -. .irtudes /(N'.
0mergency 1isaster Nursing