SHOCK

Inclusion Criteria:  Any patient experiencing signs and symptoms consistent with shock and hypoperfusion.  Refer also to TRAUMA, specific arrhythmia, and ALLERGIC REACTION Guidelines, and to the NEEDLE THORACOSTOMY Special Procedure.

Basic Level

  1. Assess and support ABCs.
  2. Initiate SPINAL MOTION RESTRICTION, if indicated.  Place the patient supine and elevate the legs, unless contraindicated.
  3. Control any obvious external hemorrhage.
  4. Cover the patient to avoid heat loss, but do not over-bundle.
  5. Administer oxygen via non-rebreather mask at 10-15 lpm (100% NRBM) or assist ventilations via BVM, if indicated.
  6. Begin transport as soon as possible.

Advanced Level

  1. Continuously monitor ECG, SpO2 and ETCO2.
  2. Establish one large bore IV and infuse Normal Saline according to the following guidelines:

Hypovolemic/Hemorrhagic shock:

Adult

Pediatric

Cardiogenic Shock - Assure heart rate and rhythm are adequate, then:

Adult

Pediatric

All Other Forms of Shock (Except Tension Pneumothorax):

Adult

Pediatric

Obstructive Shock due to Tension Pneumothorax
(Pneumothorax, with Hypotension and Severe Hemodynamic Compromise):

Adult

Pediatric

  1. Continuously monitor vital signs, ECG, SpO2, ETCO2 and neurological status during transport.
  2. For additional patient care considerations not covered under standing orders, consult BioTel.