Understanding the different types of shock is essential.

The ATLS Casualty Assessment

S.A.F.E. Approach Quick Look Primary Survey Assess Airway: Perform Manual Airway manoeuvre : Head tilt Chin Lift (Jaw Thrust if C-Spine injury suspected). Suction airway if secretions present. Insert Basic Airway Adjunct. Primary choice should be Oro-Pharangeal Airway Reassess Airway Assess Breathing: (RISE / FALL) Ventilate with 100% oxygen. Non-rebreather mask if RR > 9 Or < 43 (O2 @ 15L/min) Ventilate with B.M.V.  if RR < 8 Or > 44 (O2 @ 15L/min). Reassess Breathing. Assess Circulation: Take a Pulse Rate, Estimating Blood Pressure Apply pressure to hemorrhages (Immediately if catastrophic… takes priority over AIRWAY). Applying tourniquet (Immediately if can’t be controlled). Reassess Circulation.

The DMT must be able to quickly identify the symptoms of Shock:

• ⬆︎ Respiratory Rate
• ⬇︎ Blood Pressure (loss of radial pulse if B/P is below 90mm/hg systolic)
• ⬆︎ Heart Rate
• ⬇︎ Urine output

If these are present the DMT MUST assume shock is present. All shock will have these generic symptoms

• Hypovolaemic Shock; Pale / Cold / Clammy / Possible lots of blood!
• Cardiogenic Shock; Pale / Cold / Clammy / Cold Feet
• Septic Shock; Hot / Clammy
• Neurogenic Shock; Flushed / Hot dry skin
• Anaphylactic Shock; Blotchy red skin (Trunk, neck & arms), Swelling: (Eyes,  neck swelling, Swollen tongue / airway. Breathing difficulty (Wheezy, similar to Asthma).

Treatment of Shock:

• Treat underlying cause: Stop bleeding, take out of heat, give episodes-pen(anaphylaxis) etc..
• Rapidly gain vascular access. (IV Cannula or intra-osseous)
• Administer Intravenous IV Fluid (IVI).

• DMT Course Manual; Section 3.3.1 to 3.3.6

Now proceed to the quiz: > > > > > >