This document provides an overview of a powerpoint presentation on shock and resuscitation. It discusses ethical issues in resuscitation including withholding attempts, irreversible death, and do not resuscitate orders. It also covers providing emotional support for family members. Signs of irreversible death and details about do not resuscitate orders are described. The document then reviews anatomy and physiology of the respiratory and cardiovascular systems as well as causes, types, signs, and treatments of shock. Specific information is given on pediatric and geriatric assessments for shock.

1. PREVIEW OF
EMT/EMR
SHOCK & RESUSCITATION
POWERPOINT TRAINING
PRESENTATION

2. ETHICAL ISSUES IN RESUSCITATION
Withholding resuscitation attempts
Irreversible death
Do Not Resuscitate (DNR) orders
Provide emotional support for family

3. IRREVERSIBLE DEATH
Signs include
Decapitation
Other obvious mortal injuries
Decomposition
Postmortem lividity
Postmortem rigidity
Many areas require EKG confirmation

4. DO NOT RESUSCIATATE ORDERS
Advanced directive created by doctor and
patient
Normally is required to be shown at time of
death
Indicates patients wishes not to be resuscitated

5. EMOTIONAL SUPPORT FOR FAMILY
Ask if they need support from support from
Pastor-either family or on call
Other family members
Some employers provide “Employee
Assistance Programs” (EAP) and have a 24
hour phone assistance
EMT’s must maintain dignity & decorum

6. RESPIRATORY SYSTEM
Fresh oxygen to enter the
lungs and blood supply
Respiratory waste products
(CO2) to leave the blood
and lungs

7. CARDIOVASCULAR SYSTEM
Vascular System
Arteries carry blood to tissues
Veins carry blood to heart
Heart contraction can be
felt as a pulse Radial
Carotid
Brachial
Femoral
Veins (blue)

8. RESPIRATORY FAILURE
Definition- Reduction of breathing to the point
where oxygen intake is not sufficient to
support life

10. RESPIRATORY ARREST
Definition
Condition that respirations have stopped and
can shortly lead to cardiac arrest if not
immediately treated

11. GENERAL REASONS FOR THE
HEART TO STOP BEATING
Sudden death and heart disease
Breathing stops, especially in infants and
children
Medical emergencies
Trauma

12. CHEST COMPRESSIONS
Factors which decrease effectiveness
Compression that are too shallow
Slow compression rate
Sub-maximum recoil
Frequent interruptions

13. SHOCK
(POOR PERFUSION)
Results from inadequate delivery of oxygenated
blood to body tissues

14. DEFINITION
Perfusion is the passage of blood and oxygen
and other essential nutrients to the body’s
cells
While delivering these essentials to the body’s
cells, the circulatory system is also removing
waste such as carbon dioxide from the cells

15. DEFINITION
Shock is a state of hypoperfusion, or inadequate
perfusion of blood through body tissues
Hypoperfusion can lead to death if not
corrected

16. BLOOD VOLUME BY SIZE
Adult- 4-5 liters (females may be slightly higher)
Child- 2.4 Liters (66 pounds)
Infant- 0.8 Liter ( 22 pounds)
Volume is regulated by kidneys

17. ANATOMY & PHYSIOLOGY REVIEW
Heart & blood vessels
Physiology of respiration
Gas exchange
Alveolar level
Tissue level
Circulation
Pulmonary
Systemic

18. HEART & BLOOD VESSELS

19. PULMONARY CIRCULATION
Is the portion of the cardiovascular system that
carries blood between the heart and the
lungs

20. DISRUPTIONS THAT
CAN CAUSE SHOCK
Inadequate fluid/blood – blood/water loss
Failing pump/heart
Disease or injury to conduction system
Damage to cardiac muscle
Leaky or dilated container/vessels
Loss of nervous control
Severe allergic reactions
Massive infection
Hypothermia

21. COMPENSATED SHOCK
Earliest phase
Up to 5 to 15 % blood loss
Body compensates by activating the
sympathetic nervous system

22. IRREVERSIBLE SHOCK
Rapid deterioration of the cardiovascular
system
Greater blood shunting to heart & brain
Cell death begins which will progress over
several days

23. S & S OF
IRREVERSIBLE SHOCK
Marked decrease in level of responsiveness
Decreased respiratory rate
Profound respiratory rate
Decrease in pulse rate
Patient feels impending doom

24. SHOCK DUE TO FLUID LOSS
Hypovolemic (hypovolemia)
Examples
Signs and symptoms

25. CARDIOGENIC SHOCK
(PUMP FAILURE)
Caused by profound failure of the heart
Severe MI
Severe heart failure
Trauma to the heart
There is good peripheral vascular
resistance & adequate blood volume,
but the heart is not pumping properly

26. NEUROGENIC SHOCK
The nervous system is no longer able to
control the diameter of the blood vessels
leading to hypovolemia
Usually from severe brain or CNS injury

27. SEPTIC SHOCK
(SEPSIS)
Caused by an infection causing massive
vasodilation
Blood plasma is lost through the vessel
walls
Results in hypovolemia

28. PEDIATRICS
Common causes of shock
Trauma
Fluid loss
Infection
Anaphylaxis
Congenital heart disease
Chest wall injury

29. GERIATRICS
Assessment
Body system changes affecting presentations
of shock
Vital sign changes
Airway
Breathing
Circulation
Skin

30. MEDICATIONS MAY MASK
SHOCK SYMPTOMS
Beta Blockers
Prevent increase in heart rate
Decompsensation will be more will happen
more quickly due to inability to raise heart
rate & constrict blood vessels

31. To purchase this presentation go to
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