Nursing

Nursing

Shocks

Shock is a life-threatening medical illness that develops when insufficient blood flow to the body. The condition mainly manifests due to failure of access to required oxygen by the body organs, which translates to dysfunction of the different body organs (Hayas Haseer Koya & Paul, 2020). Several factors, such as hemorrhage, infection, heart attack, and severe allergic reaction, can result in shock. Skin that is pale or blue, a weak pulse, low blood pressure, rapid breathing, and bewilderment are all signs of shock. Shock can result in organ failure and death if it is not promptly treated. The most common types of shock are cardiogenic, hypovolemic, obstructive, distributive, and septic shocks.

Cardiogenic Shock

Cardiogenic shock occurs when the heart cannot pump enough blood to meet the body's needs. Heart attack, heart failure, or another cardiac event may be to blame. Low blood pressure, a rapid heartbeat, and shortness of breath are symptoms (Houston, 1990). Giving patients medicines to enhance heart health and increase blood flow is a common treatment. Sometimes a mechanical aid is required to assist the heart in pumping blood.

Pathophysiology of Cardiogenic Shock

Cardiogenic shock occurs when the heart cannot pump enough blood to meet the body's needs. The inability to pump blood may occur due to a heart attack, heart failure, or other heart-related illnesses. The heart is the muscle that pumps blood throughout the body. The left and right atria, along with the left and right ventricles, make up its four chambers that play a significant role in the heart's pumping mechanism (Houston, 1990). Blood with more oxygen is pumped from the left side of the heart to the body, while blood with less oxygen is sent to the lungs from the right side. The largest and most powerful cardiac chamber is the left ventricle. For proper operation, the heart muscle requires a steady blood flow rich in oxygen to facilitate appropriate ventricle functioning. When the heart muscle is injured, it is less effective in pumping blood which translates to less oxygen transported to the body tissues (Houston, 1990). As a result, fluid may accumulate in the lungs and other organs, and blood pressure may drop, translating into the long-term effect of suffocation of the heart and shock results.

Hypovolemic Shock

Hypovolemic shock is a condition that occurs when blood or fluid within the body is lost, resulting in a drop in blood pressure leading to low blood volume transported to the body organs. If not treated right once, this could cause the body's organs to shut down and be fatal. Shallow breathing, pale or blue skin, cold and clammy skin, sweating, and a weak and quick pulse are all signs of hypovolemic shock (Houston, 1990). Transfusions of blood and intravenous fluids are used to replenish fluid and blood levels as part of the treatment for hypovolemic shock.

Pathophysiology of Hypovolemic Shock

Hypovolemic shock has complicated pathogenesis that is still not fully understood. However, several elements are usually thought to be responsible. Reduced blood volume, lower blood pressure, and faster heart rate contributes to these contributing causes. Decreased blood volume is the most significant factor in developing hypovolemic shock (Houston, 1990). A decrease in blood volume leads to a reduction in blood pressure that increases the heart rate. The combination of these mechanisms leads to decreased blood flow to the tissues and organs, reducing the oxygen content in the tissues and leading to tissue dysfunctions.

Decreased blood pressure is also a significant factor in developing hypovolemic shock. Decreased blood pressure mainly results from reduced blood volume. The blood pressure decreases when blood volume decreases (Houston, 1990). The decrease in blood pressure leads to reduced blood flow to the tissues and organs, which translates to poor oxygenation of tissues due to insufficient pressure to push the oxygenated blood to the body organs and aggravates the development of hypovolemic shock. Increased heart rate is the last mechanism explaining the manifestation of hypovolemic shock. The heart can only pump blood to the body parts when a threshold is reached. Increased heart rates without achievement of the needed threshold least to limited blood delivered to the target organs, which is an insinuation of low oxygen in the tissues and shock results.

Obstructive Shock

Obstructive shock is a type of shock that occurs when blood flow is obstructed. A heart attack, a blood clot, or an accident that affects the arteries are only a few causes of this (Houston, 1990). If obstruction shock is not treated immediately, it can cause organ damage and even death.

Pathophysiology of Obstructive Shock

An increase in vascular resistance and a decrease in cardiac output define the pathogenesis of obstructive shock. Blood flow to the organs is reduced as a result, and the heart experiences an increase in venous return (Houston, 1990). A decrease in cardiac output and an increase in vascular resistance result from the consequent increase in preload and afterload. The increased preload causes less blood to reach the organs and more blood to return to the heart through veins. A rise in right ventricular end-diastolic volume and pressure, in turn, causes an increase in pulmonary artery pressure and a rise in left ventricular end-diastolic volume and pressure as a result of the increase in venous return. A decrease in cardiac output and an increase in vascular resistance result from this rise in left ventricular end-diastolic volume and pressure (Houston, 1990). Overall, this causes less blood to reach the organs and more blood to return to the heart through veins.

Distributive Shock

Distributive shock occurs when blood flow is inadequate to meet the body's needs. Numerous things, such as low blood pressure, high blood pressure, or injury to the blood vessels, might contribute to this (Houston, 1990). Distributive shock can cause death or serious organ damage.

Pathophysiology of Distributive Shock

When the vasoconstrictor and vasodilator systems are out of balance, distributive shock occurs, leading to widespread vasodilation. As a result, the blood pressure drops, and the heart rate rises. The body releases more catecholamines to compensate for the deviation, constricting the blood vessels (Houston, 1990). The overall effect is an increase in total peripheral resistance, which causes blood flow to the organs to diminish. Organ malfunction and tissue hypoxia may result from this.

Septic Shock

Septic shock is a life-threatening condition when an infection in your body causes your blood pressure to drop to a dangerously low level. Your blood pressure may fall so low that your organs begin to die from the lack of blood supply. A fall in blood pressure can be fatal and can occur very quickly.

Pathophysiology of septic Shock

Four key elements characterize septic shock's pathophysiology: an initial rise in blood pressure and cardiac output, a subsequent fall in both, a decline in tissue perfusion, and lastly, an increase in mortality. These characteristics result from a sophisticated interaction between the host's immunological response, the microbes, and the numerous organs and systems concerned (Houston, 1990). The body's reaction to the infection causes the initial rise in blood pressure and cardiac output. Vasoconstriction, increased heart rate and contractility, and other immune response mediators are all brought on by the release of cytokines. Blood pressure and cardiac output rise as a result of this. But when the infection worsens, the body's reaction starts to alter. Vasoconstriction, increased heart rate and contractility, and other immune response mediators are all brought on by the release of cytokines (Houston, 1990). As a result, both blood pressure and cardiac output are reduced. Organ injury and mortality may result from decreased tissue perfusion caused by decreased cardiac output.

Risks of morbidity and mortality and the preparation and prevention measures for one type of natural disaster

A natural disaster is a catastrophic incident brought on by a natural occurrence like a flood, hurricane, earthquake, or tornado. There are significant hazards of morbidity and mortality linked to natural disasters. For instance, the CDC in the US estimates that each year, natural disasters cause $14 billion in economic damages and around 2,000 fatalities.

The danger of natural catastrophes can be reduced by preparation and prevention. The CDC advises people to make an emergency plan for themselves and their families, including a planned meeting site, a list of emergency contacts, and a supply of food, water, and medication. In the event of a natural disaster, it is also crucial to have a strategy in place for evacuating the area. Families and individuals should also be aware of local risks and potential hazards, as well as any prospective natural disasters and their warning signs. When a natural disaster is approaching, it's crucial to evacuate to a safe area as directed by local authorities.

Disaster Closet

A disaster closet is a designated storage area in the emergency department for supplies and equipment during a disaster. There are many ways to set up a disaster closet in the emergency department, but some common elements include: Stocking the closet with essential supplies as the first step (Chartoff & Roman, 2020). The stocking may contain supplies for airway control, intravenous fluids, and personal protection equipment. Organizing the supplies is the second step. Supplies should be organized such that they are simple to find and use in an emergency. Training staff on the use of the supplies is the third step. The disaster closet's materials should be known to the staff, who should also know how to use them in an emergency (Prasad & Francescutti, 2017). Regularly checking and restocking the supplies is the fourth step. Regular inspections of the catastrophe closet's contents are necessary to ensure that everything is in working order and that the supplies are still acceptable for the potential emergency.

A disaster closet should contain a flashlight, a first-aid kit, a fire extinguisher, a whistle, a radio, a phone charger, and a map. The disaster closet should be accessible to everyone in the household. The disaster closet should be locked so only authorized personnel can access it (Prasad & Francescutti, 2017). There are a variety of drills that can be conducted concerning the disaster closet, depending on the specific needs of the organization. Some examples of drills that could be performed include a Fire drill to test the fire alarm system and evacuation procedures, an earthquake drill to test the building's earthquake safety procedures, a Tornado drill to test the building's tornado safety procedures, a flood drill to test the building's flood safety procedures, evacuation drill to test the evacuation procedures for the entire building.

Pathophysiology of burns

Burns have complicated pathophysiology that incorporates numerous processes. Burns cause tissue damage due to the tissue being exposed to heat, chemicals, or electricity. The tissue may get dehydrated due to this exposure, which will cause the cells to shrink and die Hettiaratchy & Dziewulski, 2017). Additionally, the disclosure may cause the tissue's proteins to denature, resulting in cell death. Additionally, tissue harm and even death can result from the inflammatory reaction to burns.

First Degree Burns

A first-degree burn is a burn that only affects the epidermis or the first layer of skin. The skin will seem bloated and red, which might hurt Hettiaratchy & Dziewulski, 2017). Home cures for first-degree burns typically include cool compresses and over-the-counter pain relievers.

Second-degree burns

Second-degree burns can result in pain, redness, swelling, and blistering and are more severe than first-degree burns. There could be harmful to the underlying tissue and possibly white or discolored skin. Heat, chemicals, electricity, or radiation can all result in second-degree burns. A second-degree burn requires pain medication, sterile dressing, and chilling of the region with cool water Hettiaratchy & Dziewulski, 2017). You might need to visit a doctor or travel to the hospital if the burn is severe or deep.

Third-degree burns

A third-degree burn damages the underlying tissues and penetrates all layers of skin. Full thickness burn is another name for this kind of injury. Burns of the third degree are the most dangerous and can even be fatal. Third-degree burn treatment frequently involves hospitalization and may necessitate skin grafting Hettiaratchy & Dziewulski, 2017). Many different things, such as fire, lightning, chemicals, and hot liquids, can result in third-degree burns. Three key symptoms, including charred skin, white or blackened skin, and deep tissue injury, indicate third-degree burns. These burns can be excruciatingly painful, but because the nerves have been killed, they might not be at first. Third-degree burns might result in major side effects like infection and scarring. 

Pathogenesis and Progression of Ebola

Ebola is a viral hemorrhagic fever that affects humans and primates. The Ebolavirus, a member of the Filoviridae family, is responsible for the disease. The five subtypes of the Ebolavirus are: Zaire ebolavirus, Sudan ebolavirus, Ta? Forest ebolavirus and Bundibugyo ebolavirus have been linked to human illness (CDC, 2020). Reston ebolavirus, the fifth subtype, has only been identified in non-human primates.

It is believed that interaction with infected animals like bats, monkeys, and apes can spread the Ebolavirus to people. The virus then spreads from person to person, frequently after coming into touch with blood or bodily fluids of an infected person. Typically, the sickness takes 2 to 21 days to incubate. Ebola symptoms include fever, a bad headache, muscle pain, weakness, vomiting, diarrhea, and hemorrhaging (CDC, 2020). Gums, the nose, the eyes, and the gastrointestinal tract are just a few of the places where bleeding can happen. Ebola is a lethal illness with case fatality rates ranging from 50% to 90% (CDC, 2020).

Safety Concerns were raised during the Ebola pandemic.

During the 2014 outbreak, several safety concerns were addressed. Higher sanitation and hygiene standards in the impacted communities were among the most crucial. As part of this, it was ensured that individuals had access to clean water and that food was properly prepared and cooked. Making ensuring people were protected against the Ebola virus was another issue. The protection was crucial for medical professionals and other individuals who might contact the infection (CDC, 2020). In management o the virus and reducing its spread, it was crucial to ensure that those who had Ebola were treated in isolation.

References

CDC. (2020, April 14). Ebola virus disease Information for Clinicians in U.S. Healthcare Settings | For Clinicians | Ebola (Ebola Virus Disease) | Ebola Hemorrhagic Fever | CDC. Www.cdc.gov. https://www.cdc.gov/vhf/ebola/clinicians/evd/clinicians.html#:~:text=Top%20of%20Page-

Chartoff, S. E., & Roman, P. (2020). Disaster Planning. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK470570/

Hayas Haseer Koya, & Paul, M. (2020). Shock. Nih.gov; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK531492/

Hettiaratchy, S., & Dziewulski, P. (2017). Pathophysiology and types of burns. BMJ, 328(7453), 1427–1429. https://doi.org/10.1136/bmj.328.7453.1427

Houston, M. C. (1990). Pathophysiology of Shock. Critical Care Nursing Clinics of North America, 2(2), 143–149. https://doi.org/10.1016/s0899-5885(18)30816-5

Prasad, A. S., & Francescutti, L. H. (2017). Natural Disasters. International Encyclopedia of Public Health, 215–222. https://doi.org/10.1016/B978-0-12-803678-5.00519-1