Component Task: Management of Shock: Subsequent Management

This is an emergency or urgent care rendered by the nurse/midwife to a client/mother to avert or restore a condition where the circulatory system cannot provide adequate blood supply to vital organs of the body.

Aims

·         Improve blood supply to vital organs in the body

·         Prevent irreversible organ damage

·         Replace fluids and electrolytes

·         Identify the cause and manage it

·         Prevent anaerobic metabolism in the tissue

·         Offer appropriate supportive care

Requirements

1.        Tray for IV line

·         Large bore IV cannula

·         Gallipot

·         Cotton wool swabs

·         Receiver

2.      Tray for vital signs

3.      Oxygen apparatus

4.      Pulse oximeter

5.      Torch light

6.      Blood sample bottles

7.       IV fluids (Ringer’s Lactate or Normal Saline)

8.      Airway

9.      Ambu bag

10.    Oxygen face mask/Nasal prongs

11.      Glucometer with strips

12.    Lancet

13.    Emergency drug

·         Antihistamine

·         Epinephrine

·         Adrenalin

·         Uterotonic drug

·         Magnesium sulphate

·         Antihypertensive drug

14.    Blood volume expanders

15.    Sterile gauze swabs

16.    Speculum

17.    Swab holding forceps

18.    Patella Hammer

19.    Suction Apparatus

Steps

1.        Reassess the client conditions of signs of improvement

2.      Continuing monitoring of vital signs and note any deviations

3.      Carry out radiological and other investigations after client is stable

4.      Monitor intake and output

5.      Administer prescribed drugs

6.      Manage according to WHO/GHS protocol if the cause of shock is bleeding or infection

7.       Communicate the progress of client to family or significant others

8.      Seek or refer management if client condition fails to improve or stabilize

9.      Maintain Infection, Prevention and Control measures throughout management

10.    Record and report all information in the Maternal and Child Health Book (Manual or Electronic)