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.
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I don't want you to miss any one of these lessons. Now, 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 this 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. 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 supposed to... 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 a tension pneumothorax. So what happens in a pneumothorax?
Well, pressure, 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. Tension pneumothorax 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 around 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 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, or the hypoperfusion, okay?
That dump of epinephrine, norepinephrine, fighting back. With these patients, what they have 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 comes in septic. People think, why are they treated with vasopressors? That's why.
Because the naturally occurring ones are completely shut off and the blood vessels just open 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 over 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 an 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 stridor and hives, that's two. What about if you're nausea, vomiting on top of that?
That's three. GI, respiratory, we have our skin. Make 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. Alright, 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 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 a video study course, the 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.
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