if you want to understand shock at a deep level watch this entire video i'm going to break down every single type of shock here we go [Music] hey thanks for joining us my name is evan the paramedic coach if you're watching this video right now hit the like button and smash that subscribe button i don't want you to miss any one of these lessons now where today we're talking about the types of shock and we're starting with cardiogenic shock now the easiest way to understand cardiogenic shock and remember it now there's four types of shock but there's one subtype that we're going to talk about later on so make sure to watch the entire video to understand each type okay now cardiogenic shock how does that come about most commonly could be heart failure like chf the heart is too weak it literally fails as a pump that's this is cardiogenic shock that is chf so when chf gets really bad that can end up in a cardiogenic shock where your blood pressure goes way down right hypoperfusion because your heart fails as a pump now what else can happen in cardiogenic shock mi that's myocardial infarction too much heart muscle has died due to a coronary artery being blocked okay that's an mi if i can put it to you simply cardiogenic shock is the heart's fault the heart made it happen whether it's chf or mi now let's talk about the second type of shock let's go to obstructive totally different obstructive shock defined simply is something that is suppressing blood flow from happening it's obstructing blood flow from happening for example remember in cardiogenic shock we talked about the heart made it happen the heart itself failed as a pump that's cardiogenic obstructive could be pulmonary embolism what happens in pulmonary embolism we have blood flow being obstructed by that piece of plaque going through into that pulmonary artery system right there's number one what about number two number two could be attention pneumothorax so what happens in a pneumothorax well pressure that that gradient of pressure moves across let's say we get shot over here on the right side pressure builds until a point where it can obstruct heart blood flow and squeeze the heart is it the heart's fault the heart didn't do anything wrong since you do more thorax was the culprit it's obstructive okay the final piece i want you to think about sneaky one is cardiac tamponade okay so if we have that pressure on the heart squeezing the heart it's not the heart's fault it's around the heart okay that is obstructing the heart to do its job but it's not the heart failing as a pump because it's having a heart attack because the heart is failing as a pump it's an outside force that is obstructing blood flow that is obstructive shock right there now we're going to move on to distributive sneaky one here now here it is distributive shock is the type of shock that has three subtypes underneath so remember this distributive shock has three subtypes how many three now you won't forget it now here it is we have sepsis we have neurogenic we have anaphylaxis now let's break these down and what makes distributive shock special here it is let's say you're bleeding out right and we're going to talk about that last type of shock where you might be bleeding out okay your body is going to fight back so while you while you may be in shock maybe you'll find that patient at 80 over 60 80 over 50. that diastolic blood pressure represents your body trying to fight back from what's going on the shock but the hypoperfusion okay that dump of epinephrine norepinephrine fighting back with these patients what they have this is very important folks please hear me on this they have an abnormal vasodilation with these types of patients sepsis neurogenic anaphylaxis distributive so when these patients go into shock they go right down there's no epi or norepinephrine compensation there's none of that here in this type of shock this is why these patients let's say someone come in septic people think wow why are they treated with vasopressors that's why because the naturally occurring ones are completely shut off and the blood vessel just opened straight up here's a clinical pro i want to give you if someone is in septic anaphylaxis neurogenic shock don't be surprised if they're 80 or 40. don't be surprised they're 80 over 30 and that could be a way to catch possibly what's going on not a rule but something to think about now let's start breaking these three down first sepsis sepsis is very simply bacteria in the blood very common roots would be the lungs like an ammonia also utis urinary tract infections those are probably the most common places where you get septic okay number one bacteria in your bloodstream and it moves on anaphylaxis now anaphylaxis is our second piece this is a allergic reaction gone wild okay if i have an allergic reaction maybe i get hives on my arms okay that's one body system anaphylaxis is two or more body systems being affected so if you have difficulty breathing and wheezing maybe strider and hives that's two what about if you're not you're vomiting on top of that that's three gi respiratory we have our skin makes sense okay good and the final piece is neurogenic very simply neurogenic has to do with the brain and the spinal cord that's the big pearl with neurogenic now let's move on to our final type of shock you need to know this right here is what people think about when we think of classic shock all right hypovolemic shock hypovolemia this is how many two pathways okay so two common pathways to hypovolemic shock one yes it would be a trauma like a major bleeding event a shooting a stabbing it could be um internal bleeding from a motor vehicle accident yes you're correct but the second piece everyone forgets it could be a severe dehydration like literally a loss of body fluids i don't want you to forget that especially when we're talking about pediatric patients because that can come up a lot on exam day now that you've been squared away and you understand the different types of shock i've created video study course a link in the description down below where i go through every single level emt advanced emt paramedic prep for school videos to help you out during school and finally national registry prep also including on the job tips and all the drug cards and all the medications you'll find in your ems drug box click the link down below if you go right now i will give you a lifetime access to the program my friends thanks so much for watching thank you for the kind words if you got a comment smash it down below hope you enjoyed this one i will see you inside i'll see you there please don't waste any time don't don't be hesitant and just do it because i know this program works and i know it's it got me to where i was where it's been a year without school from emt to hey i passed my test and 70 questions like go for it you could do it like do not hesitate and don't waste any time people that don't know you they need to they need this program this program is not a choice to me this program is a happening you take uh thousands and thousands of pages in the books and you just narrow it down and just make everything simple past the registry so uh this is great content man i promise you it's worth it took this with three weeks left to go in my class and i just i'm not sure if i would have been able to pass my course or the nremt first try without this course the fact like when i was taking the national and i would read the question and i would be like whoa evan literally just went over this in the car so it's it really it helps i got to the point where i was just ready to spill all my knowledge onto this freaking test so i'm like you know what man just go ahead go for it open it up boom congratulations you passed it was um outside of having my children that's probably not like the happiest day of my life do