Question

Mrs. LaRue, a 19-year-old woman with no previous medical history, was involved in a serious automobile accident in which her best friend died. Examination by EMT personnel first on the scene revealed she had only minor scrapes and bruises and no sign of head trauma. While en route by ambulance to the hospital, Mrs. LaRue complained of thirst and appeared restless. Further examination indicated a rapid pulse and respirations, with her blood pressure now at 100/60 mm Hg. She appeared less responsive to the paramedics. She was slipping into circulatory shock as they checked her again for internal injuries.

Discuss the contributing factors to shock in this case and the pathophysiologic changes causing the changes in vital signs..

Discuss the signs and symptoms of shock, including the rationale for each, as seen in the early stage, and as compensation mechanisms respond.

Discuss emergency and follow-up treatment for shock and for complications that may arise if not treated quickly.

Compare the types of shock, giving a specific cause, classification, and any significant changes in onset or manifestations.

Answer 1

Circulatory shock results of less blood supply to the vital organs leads to metabolic disturbances and further reversing and causing ischemia.

Symptoms of shock

• Agitation
• Anxiety
• Rapid heart rate due to cardiac output
• Pale, clammy skin due to less perfusion
• Light headedness faintness increased intracranial pressure
• Less urine output due to lessen metabolic function
• Chestpain due to exaggerated cardiac activity

Treatment modalities

• Ensure emergency medical treatment as far as possible
• Maintain airway
• Hemodynamic monitoring
• Maintain oxygenation
• Vitalsigns and spo2 monitoring
• Initiate IV access
• Fluid therapy
• Emergency medication as per doctor's order

Follow up

• Hemodynamic monitoring
• Vital signs
• Continue care
• Maintain nutrition ( TPN/ NG tube feeding)
• Catheterization
• Continue monitoring