Emergency response to non-traumatic shock

In the media, we were suddenly shocked and collapsed on the street, and our lives were threatened, but fortunately we survived. Occasionally read an article. What can we do when we witness such a situation or when a close friend is in such danger?

Learn how to respond in an emergency.

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1. Overview of non-traumatic shock

1) Definition

Shock is a circulatory dysfunction caused by insufficient delivery of oxygenated blood to each part of the body. “Oxygen and nutrients required by tissue cells A situation in which oxygen and nutrients are supplied to tissues in a capacity that is less than the required amount is called shock. It is a state of deficiency of nutrients”.

2) Cause

All injuries affect the circulatory system to some degree, so first responders should always be prepared for shock and be prepared for the victim's shock. The three elements of the circulatory system necessary to understand shock are: Pumps (heart function), plumbing (vascular function), adequate amount of fluid flowing through the tubing (blood function), and appropriate amount of fluid flowing through the tubing (blood function). of these three elements Damage to any of them results in loss of blood in the tissue, resulting in shock.

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2. Classification of shock

Shock is classified according to the malfunction of the three elements of the circulatory system: the heart, blood, and blood vessels.

① Hypovolemic shock

Hypovolemic shock may include massive bleeding inside or outside the body, traumatic injury, long bone or open fracture, severe dehydration due to vomiting and diarrhea, plasma loss due to burns, and osmotic dysfunction. It is caused by diabetic acidosis and excessive sweating due to urinary action.

② Cardiogenic shock

Cardiogenic shock occurs when the heart's pumps fail, resulting in inadequate tissue perfusion and oxygenation. These cardiogenic shocks include acute myocardial infarction, arrhythmias, and high blood pressure. It can be caused by congestion, heart trauma, pulmonary edema, severe congestion, heart failure, and aortic aneurysm dissection.

③ Neurogenic shock

Causes include damage to the central nervous system, spinal cord, sepsis caused by bacterial infection, hypersensitivity reaction, insulin overdose, or Addisonian crisis caused by hormonal imbalance. it burns.

④ Septic shock

Septic shock occurs when there is a widespread infection that affects every physiological system in the body. Examples of primary infections leading to sepsis include spread of urinary tract infections, Peritonitis, staphylococcal, streptococcal infection, pneumonia, endocarditis, etc. Such shock patients are difficult to see in prehospital conditions. Mainly elderly, alcoholics or new can be seen in newborns.

⑤ Anaphylactic shock

It is a type of allergic immune response with the most severe symptoms and signs. A hypersensitivity reaction occurs immediately after contact with a causative substance in allergy sufferers. I show up in a few hours. The following examples can cause an allergic reaction, sometimes leading to anaphylactic shock.

① Injection: Serum injection, radiocontrast agent, penicillin, drug, hormone injection

② Ingested food (shellfish, milk, nuts), medication

③ Suction: dust, pollen

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3. Common situations in which shock may be suspected.

① Lethargy

There is no strength, or the person collapses after walking or standing, or complains of dizziness. They lose interest in their surroundings and even bother to talk.

② Decreased consciousness

Talking nonsense, resisting help, being confused, having convulsive seizures, or going into a coma.

③ Pale, cold, and damp skin

When you touch the skin, it feels sticky and damp, or cold sweat forms.

④ Thin and weak pulse

When you touch the pulse on your wrist or elbow, you can hardly feel it or feel it thin and weak.

⑤ Rapid breathing

Breathe quickly as if out of breath and as if out of breath.

⑥ Mucosal dehydration

When you look into your mouth with a lot of thirst, your tongue and oral mucosa are dry and saliva is reduced.

⑦ My eyes go dark, my face and lips become pale, and sweat.

⑧ Yawning, nausea, and dilated pupils.

⑨ The pulse is fast and weak or difficult to catch.

⑩ Breathing becomes irregular and gradually weakens.

 

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4. Clinical features

① Consciousness change:

The brain is affected first by shock, which can cause restlessness and anxiety, which develops into chaos and struggle, and when it gets worse, unconsciousness.

② Skin:

As blood vessels constrict, the skin becomes pale and cold, and sweating occurs when it progresses further. ◦ Breathing: rapid, shallow breathing, with further progress the respiratory rate decreases.

③ Pulse:

A fast and weak pulse occurs. (However, bradycardia (slow pulse) may occur in neurogenic shock)

④ Characteristics of each type of shock

 Hypovolemic shock: Occurs when blood volume decreases as body fluids are lost due to vomiting, diarrhea, water restriction, and bleeding.

 Cardiogenic shock: It occurs when the pumping action of the heart is weakened.  Nervous shock: Caused by dilation of blood vessels due to nerve damage in the brain or spine.

 Septic shock: Caused by extravascular movement of body fluids due to widespread infection and toxins.

 Anaphylactic shock: Caused by a systemic allergic reaction.

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5. First aid for shock patients

Even if the victim shows no signs or symptoms of shock, first responders should take shock precautions.

① Lay down and elevate your legs by at least 30 cm.

❶ Straighten the leg if the injury is to the head, neck or chest.

❷ If the patient vomits, roll the body to the side so that material in the mouth flows out without passing into the airway.

❸ If spinal cord injury is suspected, extra caution should be exercised.

② All bleeding should be stopped, and a splint should be applied to the fractured area.

③ Keep the patient warm, but not hot.

❶ Place a blanket under the patient and cover it with a thin blanket depending on the weather.

❷ If the patient is located in a hot place, keep them cool.

④ Take the patient's pulse every 5 minutes.

⑤ Comfort the patient to relieve anxiety.

❶ Lay the patient down in a safe place and apply warming treatment to prevent loss of body temperature.

❷ Position the patient to maintain the airway so that breathing is possible.

❸ Elevate your legs by 20 to 30 cm using a blanket, etc.

❹ If there is no breathing, perform artificial respiration.

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6. Precautions for first aid for shock patients

① For head injuries, stroke patients should not raise their legs. Elevate the person's head slightly only when no spinal injury is suspected.

② Do not lay on the floor in case of breathing difficulties, chest injury, heart attack, or foreign objects stuck in the eyes.

③ Have the patient take a half-sitting position for easier breathing.

④ Patients who fall under Yin-Tong-Mu or Yin, or those who vomit, do not lie on the floor and take a recovery posture.

⑤ If spinal injury is suspected, do not move the patient.

⑥ (more than 7 months) The patient is placed on the left side to avoid compressing the vena cava.

⑦ Do not lift the injured person's leg more than 30cm. Elevation of more than 30 cm interferes with breathing because the organs in the abdomen push against the diaphragm.

⑧ Do not lift the bottom of the bed or stretcher. This interferes with breathing and slows blood flow from the brain, causing the brain to swell.

⑨ Patients should not be left unattended without warming.

⑩ Do not give the patient anything to eat or drink. You can moisten the patient's lips with a clean cloth moistened with water to keep the mouth from drying out.