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Shock Training Video
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Length: 5 min 42 sec
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Show Transcript
1
00:00:02,084 --> 00:00:06,049
Now let's cover shock. You know, the interesting thing about shock,
2
00:00:06,049 --> 00:00:15,019
which is pretty much defined by saying "it's a failure of the body to circulate oxygenated blood to cells."
3
00:00:15,019 --> 00:00:20,049
The interesting thing about it is that everybody who dies, eventually dies from some form of shock.
4
00:00:20,049 --> 00:00:26,037
So, when we're talking about emergency first aid, it's one of the things we'll always be watching for,
5
00:00:26,037 --> 00:00:30,032
along with airway, breathing, circulation, bleeding control.
6
00:00:30,032 --> 00:00:35,040
Right after we get into that circulation aspect, we think about shock symptoms.
7
00:00:35,040 --> 00:00:44,032
Shock is sometimes misunderstood as shock like psychogenic shock or psychological emotional shock.
8
00:00:44,032 --> 00:00:48,063
Like "Ahhh," scared or surprised. But that's not the kind of shock we're talking about.
9
00:00:48,063 --> 00:00:51,066
We're talking about one of the many forms of shock --
10
00:00:51,066 --> 00:00:57,024
Forms meaning we could have spinal shock, caused secondary to a spinal cord injury;
11
00:00:57,024 --> 00:01:01,018
cardiogenic shock, primarily from pump failure;
12
00:01:01,018 --> 00:01:05,013
hypovolemic shock, from loss of fluids or blood;
13
00:01:05,013 --> 00:01:10,075
anaphylactic shock, which is primarily caused from a severe allergic reaction.
14
00:01:10,075 --> 00:01:16,079
And those are the main types of shock we'll see out in the environment.
15
00:01:16,079 --> 00:01:20,025
The symptoms are pretty much going to be about the same, though.
16
00:01:20,025 --> 00:01:27,044
Decreased level of consciousness, anxiety, chilled and cold, pale, clammy,
17
00:01:27,044 --> 00:01:33,070
poor capillary refill. You pinch the nail bed, it usually takes 2-3 seconds to refill.
18
00:01:33,070 --> 00:01:38,075
If it takes more than that, we're probably showing a delay in capillary refill,
19
00:01:38,075 --> 00:01:45,073
which could be an early sign of shock. The rapid breathing, rapid pulse -- signs of shock.
20
00:01:45,073 --> 00:01:50,043
Many times, we don't know the reason why they're going into the shock,
21
00:01:50,043 --> 00:01:53,008
unless there's an obvious external trauma.
22
00:01:53,008 --> 00:01:59,036
But if it's an internal injury, if it's a brain injury, a heart injury, we won't know exactly why they
23
00:01:59,036 --> 00:02:02,046
are going into shock. We'll just know that they are showing the symptoms of shock.
24
00:02:02,046 --> 00:02:05,025
And when they do, we're going to treat it the same way.
25
00:02:05,025 --> 00:02:10,079
If we haven't already called 911, we're going to make sure our scene is safe,
26
00:02:10,079 --> 00:02:15,046
gloves are on, CPR shield is available, and activate emergency medical services.
27
00:02:15,046 --> 00:02:22,025
Then, treat the primary causes of that shock. If they're unresponsive, we're still going to check to
28
00:02:22,025 --> 00:02:27,008
see if they're breathing. If they are breathing, fantastic!
29
00:02:27,008 --> 00:02:32,089
Now we know we can move to the secondary issues -- bleeding control, shock management,
30
00:02:32,089 --> 00:02:41,060
fracture management. In this case, he is breathing, he's pale, cool, sweaty, delayed capillary refill.
31
00:02:41,060 --> 00:02:47,019
No obvious signs of external bleeding that would cause us any problems. We can now treat for shock.
32
00:02:47,019 --> 00:02:50,093
Primary treatment for shock is laying them down.
33
00:02:50,093 --> 00:02:55,010
After we've managed airway, breathing, and compressions, and it's not an issue,
34
00:02:55,010 --> 00:02:59,045
we want to make the patient as warm as possible. Why?
35
00:02:59,045 --> 00:03:04,083
Keeping the body warm helps it compensate for shock.
36
00:03:04,083 --> 00:03:11,036
If it doesn't have to vasodilate in his extremities, that helps it to shunt the blood
37
00:03:11,036 --> 00:03:17,031
to the main areas of the body -- brain, heart, the different vascular organs
38
00:03:17,031 --> 00:03:22,033
that need to be fed with oxygenated blood to stay alive.
39
00:03:22,033 --> 00:03:27,079
Keeping them warm helps that. So, when we do our demonstration, we'll show
40
00:03:27,079 --> 00:03:33,006
how we're going to cover the patient with a warm blanket to help them with this issue.
41
00:03:33,006 --> 00:03:40,036
And then, if we don't suspect any kind of spinal cord injury or hip injury or long bone fracture,
42
00:03:40,036 --> 00:03:47,033
we're going to elevate the legs, making sure to put the box or object to keep their legs elevated
43
00:03:47,033 --> 00:03:54,007
above their heart, somewhere around their knees so that we don't hyperextend their knees.
44
00:03:54,007 --> 00:03:58,008
By elevating the legs, keeping them warm, laying them down,
45
00:03:58,008 --> 00:04:03,028
and then re-assessing them for breathing and circulation, and controlling any other
46
00:04:03,028 --> 00:04:07,038
external injuries, like external bleeding, is how we're going to help this person
47
00:04:07,038 --> 00:04:12,023
combat the effects of shock and give them a second chance at survival.
48
00:04:14,075 --> 00:04:18,021
The scene is safe, my gloves are on, my CPR shield is available.
49
00:04:18,021 --> 00:04:23,092
Sir, sir, are you alright, are you okay? He appears to be breathing but he's not responsive.
50
00:04:23,092 --> 00:04:28,052
You, in the plaid shirt, go call 911 and come back. I might need your help.
51
00:04:28,052 --> 00:04:33,002
He does appear to be breathing, but he looks pale, cool, sweaty,
52
00:04:33,002 --> 00:04:40,000
low capillary refill, slow capillary refill, and he's unresponsive. I think he might be suffering from
53
00:04:40,000 --> 00:04:43,051
shock. I'm going to elevate his legs. Does anyone know how he got hurt?
54
00:04:43,051 --> 00:04:47,071
Any back injuries? We find out that we don't suspect any neck or back injuries.
55
00:04:47,071 --> 00:04:52,032
I'm going to elevate the legs, being careful not to hyperextend the knees.
56
00:05:19,052 --> 00:05:24,046
Sir, can you hear me? Can you hear me? He still appears to be breathing.
57
00:05:24,046 --> 00:05:28,038
I do not see any external hemorrhaging or bleeding that needs to be controlled.
58
00:05:28,038 --> 00:05:33,000
I'm just going to maintain re-assessment every couple of minutes and make sure
59
00:05:33,000 --> 00:05:37,035
that if there's any problems, I treat them. And wait for EMS to arrive.
00:00:02,084 --> 00:00:06,049
Now let's cover shock. You know, the interesting thing about shock,
2
00:00:06,049 --> 00:00:15,019
which is pretty much defined by saying "it's a failure of the body to circulate oxygenated blood to cells."
3
00:00:15,019 --> 00:00:20,049
The interesting thing about it is that everybody who dies, eventually dies from some form of shock.
4
00:00:20,049 --> 00:00:26,037
So, when we're talking about emergency first aid, it's one of the things we'll always be watching for,
5
00:00:26,037 --> 00:00:30,032
along with airway, breathing, circulation, bleeding control.
6
00:00:30,032 --> 00:00:35,040
Right after we get into that circulation aspect, we think about shock symptoms.
7
00:00:35,040 --> 00:00:44,032
Shock is sometimes misunderstood as shock like psychogenic shock or psychological emotional shock.
8
00:00:44,032 --> 00:00:48,063
Like "Ahhh," scared or surprised. But that's not the kind of shock we're talking about.
9
00:00:48,063 --> 00:00:51,066
We're talking about one of the many forms of shock --
10
00:00:51,066 --> 00:00:57,024
Forms meaning we could have spinal shock, caused secondary to a spinal cord injury;
11
00:00:57,024 --> 00:01:01,018
cardiogenic shock, primarily from pump failure;
12
00:01:01,018 --> 00:01:05,013
hypovolemic shock, from loss of fluids or blood;
13
00:01:05,013 --> 00:01:10,075
anaphylactic shock, which is primarily caused from a severe allergic reaction.
14
00:01:10,075 --> 00:01:16,079
And those are the main types of shock we'll see out in the environment.
15
00:01:16,079 --> 00:01:20,025
The symptoms are pretty much going to be about the same, though.
16
00:01:20,025 --> 00:01:27,044
Decreased level of consciousness, anxiety, chilled and cold, pale, clammy,
17
00:01:27,044 --> 00:01:33,070
poor capillary refill. You pinch the nail bed, it usually takes 2-3 seconds to refill.
18
00:01:33,070 --> 00:01:38,075
If it takes more than that, we're probably showing a delay in capillary refill,
19
00:01:38,075 --> 00:01:45,073
which could be an early sign of shock. The rapid breathing, rapid pulse -- signs of shock.
20
00:01:45,073 --> 00:01:50,043
Many times, we don't know the reason why they're going into the shock,
21
00:01:50,043 --> 00:01:53,008
unless there's an obvious external trauma.
22
00:01:53,008 --> 00:01:59,036
But if it's an internal injury, if it's a brain injury, a heart injury, we won't know exactly why they
23
00:01:59,036 --> 00:02:02,046
are going into shock. We'll just know that they are showing the symptoms of shock.
24
00:02:02,046 --> 00:02:05,025
And when they do, we're going to treat it the same way.
25
00:02:05,025 --> 00:02:10,079
If we haven't already called 911, we're going to make sure our scene is safe,
26
00:02:10,079 --> 00:02:15,046
gloves are on, CPR shield is available, and activate emergency medical services.
27
00:02:15,046 --> 00:02:22,025
Then, treat the primary causes of that shock. If they're unresponsive, we're still going to check to
28
00:02:22,025 --> 00:02:27,008
see if they're breathing. If they are breathing, fantastic!
29
00:02:27,008 --> 00:02:32,089
Now we know we can move to the secondary issues -- bleeding control, shock management,
30
00:02:32,089 --> 00:02:41,060
fracture management. In this case, he is breathing, he's pale, cool, sweaty, delayed capillary refill.
31
00:02:41,060 --> 00:02:47,019
No obvious signs of external bleeding that would cause us any problems. We can now treat for shock.
32
00:02:47,019 --> 00:02:50,093
Primary treatment for shock is laying them down.
33
00:02:50,093 --> 00:02:55,010
After we've managed airway, breathing, and compressions, and it's not an issue,
34
00:02:55,010 --> 00:02:59,045
we want to make the patient as warm as possible. Why?
35
00:02:59,045 --> 00:03:04,083
Keeping the body warm helps it compensate for shock.
36
00:03:04,083 --> 00:03:11,036
If it doesn't have to vasodilate in his extremities, that helps it to shunt the blood
37
00:03:11,036 --> 00:03:17,031
to the main areas of the body -- brain, heart, the different vascular organs
38
00:03:17,031 --> 00:03:22,033
that need to be fed with oxygenated blood to stay alive.
39
00:03:22,033 --> 00:03:27,079
Keeping them warm helps that. So, when we do our demonstration, we'll show
40
00:03:27,079 --> 00:03:33,006
how we're going to cover the patient with a warm blanket to help them with this issue.
41
00:03:33,006 --> 00:03:40,036
And then, if we don't suspect any kind of spinal cord injury or hip injury or long bone fracture,
42
00:03:40,036 --> 00:03:47,033
we're going to elevate the legs, making sure to put the box or object to keep their legs elevated
43
00:03:47,033 --> 00:03:54,007
above their heart, somewhere around their knees so that we don't hyperextend their knees.
44
00:03:54,007 --> 00:03:58,008
By elevating the legs, keeping them warm, laying them down,
45
00:03:58,008 --> 00:04:03,028
and then re-assessing them for breathing and circulation, and controlling any other
46
00:04:03,028 --> 00:04:07,038
external injuries, like external bleeding, is how we're going to help this person
47
00:04:07,038 --> 00:04:12,023
combat the effects of shock and give them a second chance at survival.
48
00:04:14,075 --> 00:04:18,021
The scene is safe, my gloves are on, my CPR shield is available.
49
00:04:18,021 --> 00:04:23,092
Sir, sir, are you alright, are you okay? He appears to be breathing but he's not responsive.
50
00:04:23,092 --> 00:04:28,052
You, in the plaid shirt, go call 911 and come back. I might need your help.
51
00:04:28,052 --> 00:04:33,002
He does appear to be breathing, but he looks pale, cool, sweaty,
52
00:04:33,002 --> 00:04:40,000
low capillary refill, slow capillary refill, and he's unresponsive. I think he might be suffering from
53
00:04:40,000 --> 00:04:43,051
shock. I'm going to elevate his legs. Does anyone know how he got hurt?
54
00:04:43,051 --> 00:04:47,071
Any back injuries? We find out that we don't suspect any neck or back injuries.
55
00:04:47,071 --> 00:04:52,032
I'm going to elevate the legs, being careful not to hyperextend the knees.
56
00:05:19,052 --> 00:05:24,046
Sir, can you hear me? Can you hear me? He still appears to be breathing.
57
00:05:24,046 --> 00:05:28,038
I do not see any external hemorrhaging or bleeding that needs to be controlled.
58
00:05:28,038 --> 00:05:33,000
I'm just going to maintain re-assessment every couple of minutes and make sure
59
00:05:33,000 --> 00:05:37,035
that if there's any problems, I treat them. And wait for EMS to arrive.
Shock Training Summary:
A conscious/responsive shock victim may exhibit symptoms of restlessness, fear, shivering, rapid breathing and pulse rate, sweating, nausea, vomiting, headache, and/or tiredness. They may become unresponsive and lose consciousness. An unconscious shock victim's circulatory system is failing to deliver enough oxygen, and they may therefore have a blue coloring in their nail beds, tops of hands, around the lips, and/or face. Treatment of shock begins with elevating the legs higher than the waist. You then tilt the head back and open the mouth to check breathing. If the patient is breathing less than 12 times per minute or less than 1 breath per 5 seconds, you should begin rescue breathing. To check for reasons of shock, do a secondary survey.
