Central Mindanao University

College of Nursing
Cherry Ann P. Francisco BSN IV
Emergency Disaster Nursing
Cardiogenic Shock

Hypovolemic Shock Neurogenic Shock Septic Shock Anaphylactic Shock
Definition Cardiogenic shock
is when the heart
has been damaged
so much that it is
unable to supply
enough blood to
the organs of the
body.


Hypovolemic shock is
an emergency
condition in which
severe blood and fluid
loss make the heart
unable to pump
enough blood to the
body. This type of
shock can cause many
organs to stop
working.
Neurogenic shock is a
type of medical shock
that resulted from a
disruption in the
sympathetic outflow
leading to unimpeded
vagal tone or the
control of the
autonomic nervous
system over
vasoconstriction.

Septic shock is a
serious condition that
occurs when a body-
wide infection leads
to dangerously low
blood pressure.
Anaphylaxis is a
serious allergic
reaction that is rapid in
onset and may cause
death
Signs and
Symptoms
Chest pain or
pressure
Coma
Decreased
urination
Fast breathing
Fast pulse
Heavy sweating,
moist skin
Lightheadednes
s
Loss of
alertness and
ability to
concentrate
Restlessness,
agitation,
Anxiety or agitation
Cool, clammy skin
Confusion
Decreased or no
urine output
General weakness
Pale skin color
(pallor)
Rapid breathing
Sweating, moist
skin
Unconsciousness
Hypotension
Bradycardia
Hypothermia
A rapid and deep
shallow breathing
Difficulty breathing
Cold and clammy
skin
Pale skin
appearance
Nausea and
vomiting
Dizziness and
lightheadedness
Cool, pale arms and
legs
High or very low
temperature, chills
Light-headedness
Little or no urine
Low blood pressure,
especially when
standing
Palpitations
Rapid heart rate
Restlessness,
agitation, lethargy,
or confusion
Shortness of breath
Skin rash or
discoloration
abdominal pain
Abnormal (high-
pitched) breathing
sounds
Anxiety
Chest discomfort or
tightness
Cough
Diarrhea
Difficulty breathing
Difficulty swallowing
Dizziness or light-
headedness
Hives, itchiness
Nasal congestion
Nausea or vomiting
Palpitations
Central Mindanao University
College of Nursing
Cherry Ann P. Francisco BSN IV
Emergency Disaster Nursing
confusion
Shortness of
breath
Skin that feels
cool to the
touch
Pale skin color
or blotchy skin
Weak (thready)
pulse
Fainting
Rapid and weak
pulse
Weakness is
experienced as a
result of
insufficiency in the
blood supply
Blank stares or the
eyes staring at
nothing
Anxiety
Change in mental
state or confusion
and disorientation
Unresponsive to
stimuli
Bluish discoloration
of the lips and
fingers which signify
a deprivation of
oxygen in the body
Low urine output or
urine may cease
Excessive sweating
Significant chest
Skin redness
Slurred speech
Swelling of the face,
eyes, or tongue
Unconsciousness
Wheezing

Central Mindanao University
College of Nursing
Cherry Ann P. Francisco BSN IV
Emergency Disaster Nursing
pain
Unconsciousness

Drugs/
Medications
Dobutamine
Dopamine
Epinephrine
Levosimendan
Milrinone
Norepinephrine
dopamine,
dobutamine,
epinephrine,
and norepinephrine

Beta adrenergic
blocker
Alpha adrenergic
blocker
Norepinephrine
(Levophed)
Dopamine
(Intropin)
Dobutamine
Epinephrine
(Adrenalin)
Vasopressin
(Pitressin)
Phenylephrine
Ticarcillin-
clavulanate
(Timentin)
Piperacillin-
tazobactam
(Zosyn)
Imipenem-
cilastatin
(Primaxin)
Meropenem
(Merrem)
Clindamycin
(Cleocin)
Metronidazole
Epinephrine
(adrenaline)
A beta-agonist (such
as albuterol)
Hydrocortisone
Chlorphenamine
Central Mindanao University
College of Nursing
Cherry Ann P. Francisco BSN IV
Emergency Disaster Nursing
(Flagyl)
Ceftriaxone
(Rocephin)
Ciprofloxacin
(Cipro)
Cefepime
(Maxipime)
Levofloxacin
(Levaquin)
Vancomycin
Hydrocortisone (A-
Hydrocort, Solu-
Cortef)
Dexamethasone

Treatment/
Procedures
Cardiac
catheterization
with
coronary angiop
lasty and stenti
ng
Heart
monitoring to
guide treatment
Heart surgery
(coronary artery
bypass
surgery, heart
valve
Keep the person
comfortable and
warm (to
avoid hypothermia)
.
Have the person lie
flat with the feet
lifted about 12
inches to increase
circulation.
However, if the
person has a head,
neck, back, or leg
injury, do not
Fluid is always the
initial treatment of
shock, especially
since concomitanthe
morrhagic
shock must be
excluded following
trauma. Most
institutions will
additionally
utilize pressor agent
s to
achieve hemodynam
ic stability.
Breathing machine
(mechanical
ventilation)
Dialysis
Drugs to treat low
blood pressure,
infection, or blood
clotting
Fluids given
directly into a vein
(intravenously)
Oxygen
Sedatives
Surgery
Calm and reassure
the person.
If the allergic reaction
is from a bee sting,
scrape the stinger off
the skin with
something firm (such
as a fingernail or
plastic credit card).
Do not use tweezers -
- squeezing the
stinger will release
more venom.
If the person has
Central Mindanao University
College of Nursing
Cherry Ann P. Francisco BSN IV
Emergency Disaster Nursing
replacement,
left ventricular
assist device)
Intra-aortic
balloon
counterpulsatio
n (IABP) to help
the heart work
better
Pacemaker
Ventricular
assist device or
other
mechanical
support
Pain medicine
Oxygen
Fluids, blood,
and blood
products
through a vein
(IV)

change the person's
position unless he
or she is in
immediate danger.
Do not give fluids
by mouth.
If person is having
an allergic reaction,
treat the allergic
reaction, if you
know how.
If the person must
be carried, try to
keep him or her
flat, with the head
down and feet
lifted. Stabilize the
head and neck
before moving a
person with a
suspected spinal
injury.

Dopamine (Intropin)
is often used either
alone or in
combination with
other inotropic agen
ts.
Vasopressin (antidiu
retic hormone
[ADH])
Certain vasopressors
(ephedrine, norepin
ephrine). Phenyleph
rine may be used as
a first line
treatment, or
secondarily in
patients who do not
respond adequately
to dopamine.
Atropine (administer
if bradycardia is
severe.)
emergency allergy
medicine on hand,
help the person take
or inject the
medication. Avoid
oral medication if the
person is having
difficulty breathing.
Take steps to prevent
shock. Have the
person lie flat, raise
the person's feet
about 12 inches, and
cover him or her with
a coat or blanket. Do
NOT place the person
in this position if a
head, neck, back, or
leg injury is
suspected, or if it
causes discomfort.
endotracheal
intubation
tracheostomyor
cricothyrotomy