Trauma Study Guide for the EMT Test

Shock

The EMT needs to know the causes, signs and symptoms, and emergency treatment of shock (hypoperfusion). Shock occurs when organs and tissues cannot receive an adequate flow of blood and oxygen, or perfusion.

Pathophysiology of Shock

Shock is an acute circulatory condition. It occurs because of insufficient tissue perfusion. This insufficiency creates an imbalance in oxygenation throughout the cells and tissue.

Terms/Concepts to Know: hypoperfusion, pulse pressure, sphincters

Causes of Shock

The cause of shock involves the heart’s inability to adequately pump, inadequate blood volume, or blood vessel patency or function. These conditions could be cardiac arrest, pulmonary embolism (PE), a high volume of fluid loss from diarrhea or vomiting, septicemia, or spinal cord injury.

Terms/Concepts to Know: types of shock related to the physiological causes

Types of Shock

There are various types and causes of shock. It is important for the EMT to understand the causes of, and differences among, distributive, hypovolemic, cardiogenic/obstructive, neurogenic, psychogenic, septic, and anaphylactic shock.

Terms/Concepts to Know: preload, afterload, myocardial contractility, sensitization, aneurysm

Stages of Shock

There are two stages of shock. During the stages, the body exhibits specific signs and symptoms that indicate the stage of shock or level of compensation.

Terms/Concepts to Know: compensated and decompensated shock

Patient Assessment

Certain types of shock are not visible like a fracture or bleeding would be. There are, however, emergency and medical situations and conditions in which a person is very likely to be at risk for shock. Learn the key identifiers for shock so that early treatment is possible. The patient assessment and management of shock is the same as for other emergencies: scene size-up/MOI, primary assessment, patient history, secondary assessment, and reassessment.

Terms/Concepts to Know: normal limits for blood pressure and pulse rate

Emergency Care for Shock

Caring for a patient with shock symptoms requires a focused assessment to determine the most emergent and life-threatening symptoms to address. Patients who are experiencing shock symptoms may have underlying causes that are related to chronic medical conditions or internal/external bleeding. These may require more urgent care than the shock symptoms.

Terms/Concepts to Know: common causes of shock