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.
