SYMPTOMS OF SHOCK

Hospital Corpsman Revised Edition - Complete Navy Nursing manual for hospital training purposes
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minimizes carbon dioxide concentration in the delivered breaths. Perform chest compressions by using two fingers to depress the middle of the sternum approximately ½ to 1 inch. See figures 4-16 and 4-18 for proper finger positioning for chest compressions. For both infants and children, the compression rate should be at least 100 compressions per minute. Compressions must be coordinated with ventilations at a 5-to-1 ratio. The victim should be reassessed after 20 c y c l e s o f c o m p r e s s i o n s a n d v e n t i l a t i o n s (approximately 1 minute) and every few minutes thereafter for any sign of resumption of spontaneous breathing and pulse. If the child or infant resumes effective breathing, place the victim in the recovery position. SHOCK LEARNING OBJECTIVE: Recognize the signs and symptoms of shock, and determine treatment by the type of shock presented. Shock is the collapse of the cardiovascular system, characterized by circulatory deficiency and the depression of vital functions. There are several types of shock: Hypovolemic shock–caused by the loss of blood and other body fluids. Neurogenic shock–caused by the failure of the nervous system to control the diameter of blood vessels. Cardiogenic shock–caused by the heart failing to pump blood adequately to all vital parts of the body. Septic shock–caused by the presence of severe infection. Anaphylactic shock–caused by a life-threatening reaction of the body to a substance to which a patient is extremely allergic. Multiple types of shock may be present in varying degrees in the same patient at the same time. The most frequently encountered and most important type for the Hospital Corpsman to understand is hemorrhagic shock, a type of hypovolemic shock which will be discussed later in this chapter. Shock should be expected in all cases of major injury, including gross hemorrhage, abdominal or chest wounds, crash or blast injuries, extensive large-muscle damage (particularly of the extremities), major fractures, traumatic amputations, or head injuries, or in burns involving more than 10 percent of the body surface area. SYMPTOMS OF SHOCK The symptoms of shock vary from patient to patient and even within an individual during the course of illness. Evaluation of the whole situation is more important than one particular sign or symptom. Degrees of Shock Table 4-2 provides a generalized overview of the degrees of shock and their symptoms correlated to the approximate volume deficit. 4-21 Figure 4-17.—Palpating brachial artery pulse in an infant. Figure 4-18.—Locating proper finger position to perform chest compressions in infants.

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