Mario1105 Posted February 2, 2010 Share Posted February 2, 2010 (edited) Assignment: Report on the 8 distinct types of shock im in dire need of help i need to find specific vital signs i may observe and any treatments we as basic providers may give to effect patient outcome in both the national and Rhode island protocols anything i can get help on will be hugely appreciated. Assignment: Report on the 8 distinct types of shock im in dire need of help i need to find specific vital signs i may observe and any treatments we as basic providers may give to effect patient outcome in both the national and Rhode island protocols anything i can get help on will be hugely appreciated. i mostly need websites with good info so i can back up my paper Edited February 2, 2010 by Mario1105 Link to comment Share on other sites More sharing options...
JPINFV Posted February 3, 2010 Share Posted February 3, 2010 (edited) Specific vital signs? You don't get the concept of "shock" do you? Robbins and Coltrans "Pathological Basis of Disease" offers a good primer on what shock is. Chapter 4. Edited February 3, 2010 by JPINFV Link to comment Share on other sites More sharing options...
Mario1105 Posted February 3, 2010 Author Share Posted February 3, 2010 Specific vital signs? You don't get the concept of "shock" do you? Robbins and Coltrans "Pathological Basis of Disease" offers a good primer on what shock is. Chapter 4. i get the concept of shock this is what my instructor is asking diffrent shocks can have diffrent vitals 1 Link to comment Share on other sites More sharing options...
NickD Posted February 3, 2010 Share Posted February 3, 2010 I'll stick my neck out . . . I think the point being offered you is no matter the type of shock when a patient is in "compensating" shock the vitals, especially BP will be normal for them. It isn't until the point of "decompensating" shock that you'll see vitals trending downward, sometimes in one big hurry, and by that time you and your patient are deep in the weeds. That's why we focus so much on shock prevention. In any case a one shot look at someone's vitals will tell you very little, it's all about how they are trending, so that's why your assignment sounds odd. Unless, you or I aren't understanding what's being asked for . . . Link to comment Share on other sites More sharing options...
JPINFV Posted February 3, 2010 Share Posted February 3, 2010 That was what I was getting at. Shock, by it's definition is a state of hypoprofusion. Regardless of etiology, the vital signs are going to be similar. As shock progresses from compensated to uncompensated (non-progressive to irreversible), the vital signs are going to be the pulse increasing and the blood pressure decreasing. What's going to differentiate between the different types of shock isn't vital sign ranges, but the history of the present illness and the signs and symptoms associated with it. 1 Link to comment Share on other sites More sharing options...
FireMedic65 Posted February 3, 2010 Share Posted February 3, 2010 That was what I was getting at. Shock, by it's definition is a state of hypoprofusion. Regardless of etiology, the vital signs are going to be similar. As shock progresses from compensated to uncompensated (non-progressive to irreversible), the vital signs are going to be the pulse increasing and the blood pressure decreasing. What's going to differentiate between the different types of shock isn't vital sign ranges, but the history of the present illness and the signs and symptoms associated with it. Don't waste your time. We went over this with him for quite a while in the chatroom the other night, he just wasn't even trying to get it. Link to comment Share on other sites More sharing options...
JPINFV Posted February 3, 2010 Share Posted February 3, 2010 Don't waste your time. We went over this with him for quite a while in the chatroom the other night, he just wasn't even trying to get it. So? Maybe someone else has the same question and now has an answer. Maybe something will click this time through. 1 Link to comment Share on other sites More sharing options...
Kiwiology Posted February 3, 2010 Share Posted February 3, 2010 (edited) Listen up. Shock is hypoperfusion - not enough blood getting to where it needs to go. Two broad causes .... Volumetric - not enough volume, can't move what is not there. This is hypovolemic shock Distributive - can't move what is there adequately enough. This cardiogenic, neurogenic, septic and anaphylactic. Whatever crap your instructor told you about metabloic shock is straight out of the seventies and about as much use as MAST pants and calcium. Ask him if he still thinks of "shell" as a form of shock too! Also ask him if he means metabolic acidosis or alkalosis which can shift the oxyhaemoglobin dissassociation curve due to the pH changes. That is my guess at what he means. Anyway .... symptoms will be the same depending on which stage of shock you have and the following will be present to a greater or lesser degree depending on how much blood is lost and how long them have been shocked. I'm a Titanic freak so this may be a good comparision to draw: Compenstated shock (just after it hit the iceberg, can adjust to the changes and carry on) Tachycardic (to try and increase oxygen delivery and compensate for blood loss) Tachypenic (to try and increase oxygen delivery) Nausea and cool skin (precapillary sphincters close and blood routes from extremeties and gut to vital organs) Normal or near normal BP (vasoconstriction) Early decompensation (having a bit of trouble, going down by the bow, tell 2° Lightoller to get the lifeboats ready) Some hypotension (falling cardiac output and vascular tone) Weak pulse (see above) Cold, pale extremeties (lack of blood flow) Falling level of consciousness (cerberal hypoperfusion) Late decompensation (almost overwhelmed coping ability, how far away is the Carpathia again?) Very hypotensive Absent pulses Extremely low LOC or unconscious Irreversable (body gives up as it can't fight no more, Titanic breaks in two and sinks, you die) Death You will get one or more cause specific symptoms too Cardiogenic - cardiac history, chest pain, crackles, JVD/pedal edema Anaphylactic - history of exposure, swelling, edema, crackles, hives, rash Septic - history of infection/sick, febrile, Neurogenic - history of spinal cord injury perhaps a fall Hypovoleamic - um, bleeding? Treatment .... as a basic provider oxygen and supportive care; transport fast and yell for ALS! Generally more advanced treatment is centred around the specific type of shock; Cardiogenic - fluid and inotropic support Anaphylactic - adrenaline, anti-histamines, fluids Septic - antibiotics Neurogenic (spinal) - not sure, I'd guess circulaory support maybe fluid and vasoconstrictors? Hypovolemic - controlled bleeding, volumetric support (fluid) but uncontrolled bleeding is another story, look up permissive hypotension I hope that helps. Edited February 3, 2010 by kiwimedic Link to comment Share on other sites More sharing options...
Mario1105 Posted February 3, 2010 Author Share Posted February 3, 2010 this is so you people dont think im nuts! Link to comment Share on other sites More sharing options...
JPINFV Posted February 3, 2010 Share Posted February 3, 2010 Tell him that the Pathology Bible (Robbins and Cotrans Pathological Basis of Disease) only recognizes 5 types of shock (neuro, anaphylactic, septic, hypovolemic, and cardiogenic). If he wants to argue with a text book used in medical schools throughout the country, well... it's his funeral. Of course there's Google, WebMD, EMedicine, and plenty of other online resources available. In closing, do your own homework! 1 Link to comment Share on other sites More sharing options...
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