The mainstay of treatment of any type of shock is maximising oxygen delivery to the tissues.
Initially a standard ABCDE approach is used.
Remember – if you suspect any type of shock GET HELP NOW!
(Emergency Buzzer or periarrest/arrest = 2222)
AB |
Assessment of airway and breathing. Is the airway patent? If not attempt to open airway using airway manouvres and put out arrest call on 2222 Respiratory rate and sats. Examine chest. Apply 15L of oxygen via a non re-breathe mask. ABG if possible. |
|---|---|
C |
Heart rate, BP, capillary refill. Peripherally cool/warm? IV access, as large a peripheral cannula as possible. Get blood off for FBC, U&Es, LFTs, lactate, coagulation screen and group and save sample (cross match if you suspect blood loss is the cause). Remember blood cultures if you suspect sepsis. Fluid resuscitation (except in cardiogenic shock) – start with colloid or crystalloid fluid challenge eg 250 or 500mls stat. If you suspect hypovolaemia secondary to haemorrhage consider O neg blood whilst waiting for cross matched blood. |
D |
Is the patient drowsy, confused or agitated? AVPU, Blood glucose? Pupils |
E |
Measure patient temperature Remember to have a look under the sheets – is the patient lying in a pool if blood? Is there evidence or rash/wheals? Inspection of wounds/drains. Urine output – consider urinary catheter EVALUATE the evidence by looking at patient charts including trends on SEWS chart/notes/drug chart/recent bloods etc |
