Chapter six

shock
When the body is healthy, three conditions are needed to
keep the right amount of blood flowing:
 The heart must be working well.
 An adequate amount of oxygen-rich blood must be
circulating in the body.
 The blood vessels must be intact and able to adjust
blood flow.
Shock: is a condition in which the circulatory
system fails to deliver enough oxygen-rich blood to
the body’s tissues and vital organs.

The body’s organs, such as the brain, heart and

lungs, do not function properly without this blood
supply.
Fig: 6.1 shock
types of shock
• There are several kinds of shock.
• Hypovolemic shock: happens when you lose a lot
of blood or fluids. Causes include internal or
external bleeding, dehydration, burns, and severe
vomiting and/or diarrhea.
• Septic shock: is caused by infections in the
bloodstream. A severe allergic reaction can cause 
anaphylactic shock. An insect bite or sting might
cause it.
• Cardiogenic shock:
• happens when the heart cannot pump blood
effectively. This may happen after a heart attack.
• Neurogenic shock: is caused by damage to the
nervous system.
causes of shock

 May be caused by severe injuries of all types;

 hemorrhage, heart attack or,
 los of body fluids other than blood.
 poisoning by chemicals, gasses, or drugs
 Degree of shock increased by abnormal change of body
temperature.
 Poor resistance stress.
 Aggravated by pain, rough handling and delay in
treatment.
signs and symptoms
• Restlessness or irritability.
• Altered level of consciousness.
• Nausea or vomiting.
• Pale, cool, moist skin.
• Rapid breathing and pulse.
• Excessive thirst.
 treatment objectives
• To improve circulation of the blood.
• To ensure an adequate supply of oxygen.
• To maintain normal body temperature.
first aid
• Have the person lie down. The most comfortable position.
• Control any external bleeding.
• Since you may not be sure of the person’s condition, leave him or
her lying flat.
• Do not give the person anything to eat or drink.
• Reassure the person
unconsciousness
• Definition: victim is said to be unconscious when
the patient is asleep, he/she cannot speak and has
no control over his movement.
• Victim also cannot respond to place, people and
time (PPT).
Cause of unconsciousness

• Head injury (bleeding)

• Fainting
• Heart attacks
• Poisoning
• Epilepsy
• Diabetes
Aim of giving first aid
 To find out the cause of the condition and
manage it as quickly as possible
To refer to Hospital
Level of unconsciousness
 Alertness: the patient can speak, answers,
questions and feels pain
Lethargy :the patient is awoke but answers
questions slowly- he may be confused about
what is happening and where he is.
 Drowsiness: the patient is sleep and is unable
to concentrate on what we are saying.
 Semi-consciousness: the patient is very sleep
of and has great difficulty in speaking and in
answering your questions.
 Unconsciousness: the patient is sleepy we can
not speak and has no control his movements.
checking an unconscious person
If you think someone is unconscious, tap him or her.
ask if he or she is OK.
 Use the person’s name if you know it. Speak loudly.
 If you are not sure whether an infant is unconscious, check
by:
-tapping the infant’s shoulder and shouting or,
- by flicking the bottom of feet.
If not respond, call the local EMS.
Always check to see if an unconscious person:
■ Has an open airway and is breathing normally.
■ Is bleeding severely.
• Airway
• An open airway allows air to enter the lungs for the
person to breathe.
• A blocked airway is a life-threatening condition.
• When someone is unconscious and lying on his or
her back, the tongue block the airway.
• To open an unconscious person’s airway.
• Use head tilt-chin lift technique.
fig-2 checking airway
breathing
• After opening the airway, quickly check unconscious
person.
• Use Look, listen and feel technique- Do this not more than 10s.
• Normal breathing is regular, quiet and effortless.
• If an adult is not breathing normally, give immediate
CPR.
• If a child or an infant is not breathing, give 2 rescue
breaths.
fig: 6.3 checking breathing
 for children and infants.
If no breathing, give 2 rescue breaths.
 Tilt the head back and lift the chin up.
 Child: Pinch the nose shut, then make a complete seal
over child’s mouth.
 Infant: Make complete seal over infant’s mouth and
nose.
 Blow in for about 1 second to make the chest clearly
rise.
 Give rescue breaths, one after the other
circulation

• recognizing breathing emergencies in children and

infants
• and.to act before the heart stops beating.
• Adults’ hearts frequently stop beating because of
disease.
• Children’s and infants’ hearts, however, are usually
healthy.
• When it stops, it usually is the result of a breathing
emergency
for a child: place one hand on the forehead
and tilt the head slightly past a neutral position

FIGURE 2 If you are not sure whether an infant is unconscious,

check by tapping the infant’s shoulder or flicking the bottom of the
infant’s foot
A , Give a child 2 rescue breaths with each
breath lasting about 1 second
B, For an infant, cover the mouth and nose
special situations
• While performing CPR,you may encounter certain
special situations. These include
• air in the stomach; vomiting; mouth-to-nose breathing;
• mouth-to-stoma breathing
• drowning victims.
• To avoid forcing air into the person’s stomach,
• keep the person’s head tilted back.
• Air in stomach can make person vomit and cause
complication.
 Mouth-to-Nose Breathing. you can blow into the
nose.
• With the head tilted back, close the mouth by
pushing on the chin.
• Seal your mouth around the person’s nose and
breathe into the nose.
• If possible, open the person’s mouth between
rescue breaths
• to let the air out.
 Even giving rescue breaths properly, the person may
vomit.
• roll the person onto one side and wipe the mouth clean
• If possible, use a protective barrier.
• Then roll the person on his or her back again and
• continue giving care as necessary

Fig-3If the person vomits, roll him or her

onto one side and
wipe the mouth clean
 checking an injured or ill adult
appears to be unconscious
o After checking the safety, check the person.
o check for responsiveness
-Tap the shoulder and shout, “Are you okay
-if no response call local EMN.
-if unconscious, keep face-up and head.
-if conscious, obtain consent.
o Open the airway-head tilt, chin lift.
o Check for breathing(not > 10seconds..
checking an injured or ill child or infant
Appears to be unconscious.

• After checking scene of safety.

• Check for responsiveness.

-if no response call-911 or local EMS

• Open the airway.

-tilt head and chin lift slightly .

• Check for breathing(for 10 seconds).

-if no breathing give 2 rescue breaths .

• Quickly scan severe bleeding.
Thanks for your attention