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Referencing the content of EMT-Basic training and emergency patient care

EMT Basic · Chapter 13

Shock

Learning objectives (7)

  1. Demonstrate how to complete an EMS patient care report for a patient with shock — Knowledge/skills objective (printed page 530); confirm wording in your course copy.
  2. Demonstrate how to control shock — Knowledge/skills objective (printed page 530); confirm wording in your course copy.
  3. Describe the pathophysiology of shock (hypoperfusion) — Knowledge/skills objective (printed page 530); confirm wording in your course copy.
  4. Describe the signs and symptoms of shock including compensated and decompensated. p 540) 5. Discuss key components of patient assessment for shock — Knowledge/skills objective (printed page 530); confirm wording in your course copy.
  5. Describe the steps to follow in the emergency care of the patient with various types of shock — Knowledge/skills objective (printed page 530); confirm wording in your course copy.
  6. Differentiate among the various types of shock — Knowledge/skills objective (printed page 530); confirm wording in your course copy.
  7. Identify the causes of shock — Knowledge/skills objective (printed page 530); confirm wording in your course copy.

Vocabulary (12)

Perfusion
The delivery of oxygenated blood to body tissues at the capillary level.
Shock (hypoperfusion)
A state of inadequate tissue perfusion that, if untreated, leads to cell injury and death.
Hypovolemic shock
Shock caused by low circulating blood or fluid volume — from hemorrhage, severe dehydration, or burns.
Cardiogenic shock
Shock caused by failure of the heart to pump effectively, most often after a large myocardial infarction.
Distributive shock
Shock from inappropriate vasodilation — including septic, anaphylactic, and neurogenic forms.
Obstructive shock
Shock caused by mechanical blockage of blood flow — pulmonary embolism, cardiac tamponade, or tension pneumothorax.
Septic shock
Distributive shock caused by overwhelming infection, with widespread vasodilation and capillary leak.
Neurogenic shock
Distributive shock from loss of sympathetic tone below a spinal cord injury, producing hypotension with paradoxical bradycardia.
Compensated shock
Early shock in which the body maintains blood pressure through tachycardia, vasoconstriction, and increased respirations.
Decompensated shock
Late shock with falling blood pressure, altered mental status, and failing compensatory mechanisms.
Capillary refill time
Time for color to return to a blanched nail bed; over 2 seconds suggests poor perfusion in many populations.
Orthostatic vital signs
Measurements of heart rate and blood pressure in supine, sitting, and standing positions to detect volume depletion.

Sequence practice (2 puzzles on Quiz Me)

Stages of shock progression

Order the stages of shock from earliest to latest.

  1. Compensated (normal BP, tachycardia, vasoconstriction, anxiety)
  2. Decompensated (falling BP, altered mental status, weak pulses)
  3. Irreversible (organ failure, death imminent without correction)
EMT care for the shock patient

Order the EMT priorities when shock is recognized.

  1. Ensure scene safety and use BSI precautions
  2. Manage airway, breathing, circulation (ABCs)
  3. Control external hemorrhage
  4. Provide high-flow oxygen and assist ventilations as needed
  5. Position appropriately and keep the patient warm
  6. Transport rapidly with ALS intercept if available

Quick fire sample (12 of 12 on Quiz Me)

The delivery of oxygenated blood to body tissues at the capillary level.
  1. Orthostatic vital signs
  2. Decompensated shock
  3. Obstructive shock
  4. Perfusion
A state of inadequate tissue perfusion that, if untreated, leads to cell injury and death.
  1. Obstructive shock
  2. Perfusion
  3. Shock (hypoperfusion)
  4. Cardiogenic shock
Shock caused by low circulating blood or fluid volume — from hemorrhage, severe dehydration, or burns.
  1. Hypovolemic shock
  2. Distributive shock
  3. Septic shock
  4. Compensated shock
Shock caused by failure of the heart to pump effectively, most often after a large myocardial infarction.
  1. Compensated shock
  2. Cardiogenic shock
  3. Capillary refill time
  4. Septic shock
Shock from inappropriate vasodilation — including septic, anaphylactic, and neurogenic forms.
  1. Cardiogenic shock
  2. Distributive shock
  3. Decompensated shock
  4. Compensated shock
Shock caused by mechanical blockage of blood flow — pulmonary embolism, cardiac tamponade, or tension pneumothorax.
  1. Obstructive shock
  2. Cardiogenic shock
  3. Decompensated shock
  4. Neurogenic shock
Distributive shock caused by overwhelming infection, with widespread vasodilation and capillary leak.
  1. Septic shock
  2. Capillary refill time
  3. Distributive shock
  4. Orthostatic vital signs
Distributive shock from loss of sympathetic tone below a spinal cord injury, producing hypotension with paradoxical bradycardia.
  1. Perfusion
  2. Neurogenic shock
  3. Cardiogenic shock
  4. Distributive shock
Early shock in which the body maintains blood pressure through tachycardia, vasoconstriction, and increased respirations.
  1. Neurogenic shock
  2. Compensated shock
  3. Obstructive shock
  4. Capillary refill time
Late shock with falling blood pressure, altered mental status, and failing compensatory mechanisms.
  1. Hypovolemic shock
  2. Septic shock
  3. Decompensated shock
  4. Neurogenic shock
Time for color to return to a blanched nail bed; over 2 seconds suggests poor perfusion in many populations.
  1. Septic shock
  2. Capillary refill time
  3. Compensated shock
  4. Cardiogenic shock
Measurements of heart rate and blood pressure in supine, sitting, and standing positions to detect volume depletion.
  1. Septic shock
  2. Orthostatic vital signs
  3. Compensated shock
  4. Obstructive shock

Some topics in this course differ across field references. See when sources disagree on Quiz Me before you teach from this sheet alone.

Full scored drills are on Quiz Me at /courses/nm-emt-b/chapters/13/print/. Answers are not marked on this sheet.