Lesson 5:Lesson 5:Shock & Heart Attack Shock & Heart Attack

Emergency Reference Guide p. 67-69Emergency Reference Guide p. 67-69

ObjectivesObjectives• Define Shock & discuss stages• List signs of shock• Describe when shock is threat to life• Demonstrate treatment for shock• Define heart attack• List signs & symptoms of a heart attack• Demonstrate care for a heart attack• Describe long term care for a heart attack

patient

What is Shock?What is Shock?

• Cardiovascular system is challenged • Insufficient oxygen to brain & other body parts

• What can cause Shock?– Loss of body fluids– Allergic reaction– Loss of blood pressure– Psychogenic shock (i.e. fainting)– Heart Attack

Shock Signs & SymptomsShock Signs & Symptoms

• LOR (Level of Responsiveness):

• Anxious, restless, or disoriented

• Heart rate may be rapid, weak, or irregular

• Respiratory rate rapid, shallow

• Skin Color -Temperature - Moisture:

• Pale, cool, clammy (may be pink, if allergic reaction)

• Nausea

Later Stages of ShockLater Stages of Shock

• LOR continues to decrease:– Patient becomes lethargic, apathetic,

eventually unresponsive– Heart rate (radial=wrist) grows more rapid &

weak, may disappear

Care for ShockCare for Shock

• Always care for shock until patient is in normal state

• Unmanaged Shock can lead to death

• Options for caring limited in Wilderness

• Early recognition is essential

Care for Shock Care for Shock (cont’d.)(cont’d.)

• Identify causes, such as bleeding & treat causes• Keep patient calm• Keep patient lying down or comfortable• Maintain open airway• Elevate patient’s feet about 12 inches• Monitor vital signs• Give sips of cool water to prevent dehydration, if

conscious (4 oz. every 20 min.) • Maintain patient’s normal body temperature

Position for ShockPosition for Shock

Checking and Caring for a Checking and Caring for a Heart AttackHeart Attack

• Signs & Symptoms?:– Pain in center of chest– Pressure in chest– Pain on left side may in shoulder arm, or jaw– Nausea, sweating, shortness of breath– Denial of the possibility of a heart attack– Unexplained fatigue– Sudden, sharp short lived pain outside

breastbone

Caring for a Heart AttackCaring for a Heart Attack

• Keep him/her physically & emotionally calm• Do not allow patient to walk• Call for help immediately• Help patient self-administer 325 mg aspirin, if they can

swallow (i.e. non-coated aspirin)• If patient has strong radial pulse & has Nitro prescription,

help them self-administer• If unconscious & no movement or breathing, start CPR

immediately. Use AED, if available

Making Difficult DecisionsMaking Difficult Decisions

• For delayed help CPR, how long do you try?• Keep in mind:

– Decision is your’s and based on info you have– Some people die because no advanced care is

available, no matter what you do– CPR does not sustain life indefinitely

• Survival chances not good, if direct injury to heart

• Better chances for hypothermia/lightning strike

Guidelines for EvacuationGuidelines for Evacuation

• Deciding whether to go slow or fast is important part of the care for shock/heart attack

• Evacuate, if patient is not stable• GO FAST for any patient with:

– Decreased mental status– Worsening vital signs, especially increased heart rate– Anyone you believe is having a heart attack

Making Difficult Decisions Making Difficult Decisions (cont’d.)(cont’d.)

• General Rules– Continue CPR until:

• Obvious signs of life are observed• Another trained person arrives & takes over• EMS personnel arrive & take over• You are too exhausted to continue• The scene becomes unsafe

Questions???Questions???

What else could you add to your What else could you add to your First Aid Kit?First Aid Kit?