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You obtain a SAMPLE history from the health aide which is as follows: S: Terrible cough x 3 days and a temperature of 101° F. Per the health aide, the patient had reported feeling pain when taking a deep breath when she last saw him. A: Shellfish M: Lisinopril, Aspirin, Ventolin Inhaler and Furosemide. P: Hypertension, Chronic Bronchitis, and an AMI 5 years ago. L: Unknown. The health aide reports he refused to eat during her last visit. E: Unknown During your assessment of his lung sounds, you hear rales and rhonchi bi-laterally in all fields. You obtain a full set of vitals which are: RR: 24 breaths per minute, labored and shallow RR: 120 beats per minute, week and regular BP: 68 by palpation Skins: mottled, cool, and clammy Pupils: PERL (sluggish) SpO2 Reading: 92% 1. What conditions or factors lead you to label

You obtain a SAMPLE history from the health aide which is as follows: S: Terrible cough x 3 days and a temperature of 101° F. Per the health aide, the patient had reported feeling pain when taking a deep breath when she last saw him. A: Shellfish M: Lisinopril, Aspirin, Ventolin Inhaler and Furosemide. P: Hypertension, Chronic Bronchitis, and an AMI 5 years ago. L: Unknown. The health aide reports he refused to eat during her last visit. E: Unknown During your assessment of his lung sounds, you hear rales and rhonchi bi-laterally in all fields. You obtain a full set of vitals which are: RR: 24 breaths per minute, labored and shallow RR: 120 beats per minute, week and regular BP: 68 by palpation Skins: mottled, cool, and clammy Pupils: PERL (sluggish) SpO2 Reading: 92% 1. What conditions or factors lead you to label

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You obtain a SAMPLE history from the health aide which is as follows: S: Terrible cough x 3 days and a temperature of 101° F. Per the health aide, the patient had reported feeling pain when taking a deep breath when she last saw him. A: Shellfish M: Lisinopril, Aspirin, Ventolin Inhaler and Furosemide. P: Hypertension, Chronic Bronchitis, and an AMI 5 years ago. L: Unknown. The health aide reports he refused to eat during her last visit. E: Unknown During your assessment of his lung sounds, you hear rales and rhonchi bi-laterally in all fields. You obtain a full set of vitals which are: RR: 24 breaths per minute, labored and shallow RR: 120 beats per minute, week and regular BP: 68 by palpation Skins: mottled, cool, and clammy Pupils: PERL (sluggish) SpO2 Reading: 92% 1. What conditions or factors lead you to label the patient as critical? 2. How are you going to manage and care for this patient? 3. Based on the history, what type of shock are you suspecting the patient is experiencing? 4. What are the Pathophysiologic changes associated with Distributive shock? 5. What stage of shock is the patient in? Source: Emergency Care in the Streets, eighth edition, volume 1
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