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It outlines broad clinical triggers such as heart attacks, major infections, and allergic reactions, then categorizes causes into hypovolemic, distributive, cardiogenic, and obstructive shock. The handout provides an AMLS assessment pathway, including initial observations, first impression steps, diagnostics, and ongoing management such as fluids, temperature regulation, vasopressors, and blood products.",{"@graph":69,"@context":114},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/recognizing-and-treating-shock-in-the-prehospital-setting-presentation-handout/375040/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/recognizing-and-treating-shock-in-the-prehospital-setting-presentation-handout/375040.png","ImageObject",300,407,{"name":92,"@type":93},"hdkawk","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-31","2026-09-23",true,{"@type":102,"interactionType":103,"userInteractionCount":52},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108],{"name":109,"@type":110,"acceptedAnswer":111},"What does the AMLS assessment pathway include?","Question",{"text":112,"@type":113},"It includes initial observations (scene safety, patient cardinal presentation, and primary survey), first impression steps (history, secondary survey, diagnostics, and redefining differential diagnosis), and ongoing management (fluid resuscitation, temperature regulation, vasopressors, and blood products).","Answer","https://schema.org",{"og:url":83,"og:type":116,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":118,"canonical":83},"index,follow",{"doc_id":120,"site_id":62},375040,1790814806,{"code":4,"msg":5,"data":123},{"doc_id":120,"user_id":124,"nickname":92,"user_avatar":125,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":126,"file_id":127,"file_url":128,"file_type":129,"file_size":130,"view_count":52,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":131,"language":132,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":133,"faqs":134,"seo_title":135,"seo_description":67,"update_tm":136,"read_time":137},3985747859855,"https://ap-avatar.wpscdn.com/davatar_276721f389ce27ea32af1340a28f341c","9/3/2020  \nRecognizing and Treating Shock in the Prehospital Setting  \n9/3/2020  \n\n| \u003Cbr>Special Thanks to Our Sponsor |\n| --- |\n| |\n| |\n\n9/3/2020  \n\n| \u003Cbr>Your Presenters |  |\n| --- | --- |\n| \u003Cbr>Dr. Raymond L. Fowler, MD, FACEP, FAEMS\u003Cbr>James M. Atkins MD Distinguished Professor of Emergency Medical Services, Chief of the Division of EMS Department of Emergency Medicine University of Texas | \u003Cbr>Dr. Melanie J. Lippmann, MD FACEP\u003Cbr>Associate Professor of Emergency Medicine Brown University Alpert Medical School Attending Physician\u003Cbr>Rhode Island Hospital and The Miriam Hospital |\n| \u003Cbr>Southwestern Medical Center Dallas, TX\u003Cbr>Providence, RI\u003Cbr>|  |\n\n9/3/2020  \nScenario  \nSHOCK INDEX?? Pulse ÷ Systolic  \n9/3/2020  \nWhat is Shock?  \nShock is a progressive state of cellular hypoperfusion in which insufficient  \noxygen is available to meet tissue demands  \nIt is key to understand that when shock occurs, the body is in distress. The shock response is mounted by the body to attempt to maintain systolic blood pressure and brain perfusion during times of physiologic distress. This shock response can accompany a broad spectrum of clinical conditions that stress the body, ranging from  \nheart attacks, to major infections, to allergic reactions.  \n9/3/2020  \n\n| \u003Cbr>Causes of Shock |\n| --- |\n| \u003Cbr>Shock may be caused when oxygen intake, absorption, or delivery fails, or when the cells are unable to take up and use the delivered oxygen to generate sufficient energy to carry out cellular functions. |\n|  |\n| |\n\n9/3/2020  \nCauses of Shock  \nHypovolemic Shock Inadequate circulating fluid leads to a diminished cardiac output, which results in an inadequate delivery of oxygen to the tissues and cells  \nDistributive Shock  \nA precipitous increase in vascular capacity as blood vessels dilate and the capillaries leak fluid, translates into too little peripheral vascular resistance and a decrease in preload, which in turn reduces cardiac output  \n9/3/2020  \nCauses of Shock  \nCardiogenic Shock The heart is unable to circulate sufficient blood to meet the metabolic needs of the body. Either right or left ventricular failure can lead to cardiogenic shock and may include dysrhythmias, a cardiac structural disorder, or the action of certain toxins  \nObstructive Shock  \nObstruction to the forward flow of blood exists in the great vessels or heart. Significant causes are pericardial tamponade, massive pulmonary embolism, and tension pneumothorax.  \n9/3/2020  \n\n| \u003Cbr>Signs and Symptoms of Shock |\n| --- |\n| Shock occurs in three successive phases—compensated, decompensated, and irreversible\u003Cbr>\u003Cbr>|\n\n9/3/2020  \nAMLS Assessment Pathway  \n1. Initial Observations  \na.Scene Safety Consideration  \nb. Patient Cardinal Presentation  \nc.Primary Survey  \ni. Consciousness, Airway & Breathing, Circulation/Perfusion  \n2. First Impression  \na. History Taking  \nb. Secondary Survey  \ni. Vital signs and physical exam  \nc. Diagnostic  \ni. Pulse Oximetry, Capnography, Electrocardiogram, Laboratory Studies, Compensatory Reserve  \nd. Redefine the Differential Diagnosis  \n3. Ongoing Management  \na. Fluid Resuscitation  \nb. Temperature Regulation  \nc. Vasopressor Administration  \nd. Administration of Blood Products  \ni. Transfusion Reactions  \nii. Hemolytic Reactions","cbCaibWJ2Ou1SUoE","https://ap.wps.com/l/cbCaibWJ2Ou1SUoE","pdf",4453245,45,"English","# Scenario\n## Shock Index\n# What is Shock?\n# Causes of Shock\n## Hypovolemic Shock\n## Distributive Shock\n## Cardiogenic Shock\n## Obstructive Shock\n# Signs and Symptoms of Shock\n# AMLS Assessment Pathway\n## Initial Observations\n## First Impression\n## Ongoing Management","[{\"question\":\"What does the AMLS assessment pathway include?\",\"answer\":\"It includes initial observations (scene safety, patient cardinal presentation, and primary survey), first impression steps (history, secondary survey, diagnostics, and redefining differential diagnosis), and ongoing management (fluid resuscitation, temperature regulation, vasopressors, and blood products).\"}]","Recognizing and Treating Shock in the Prehospital Setting - Presentation Handout | PDF",1790203579,113]