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Objektif
Pengenalan – renjatan
Proses peradaran darah
Punca renjatan
Jenis renjatan
Simptom renjatan
Langkah rawatan

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Di akhir sesi ini peserta akan dapat:
i. Menyenaraikan punca renjatan
ii. Menyenaraikan jenis-jenis renjatan
iii. Memberi rawatan yang betul
berdasarkan punca renjatan berlaku

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Renjatan merupakan kegagalan
sistem peredaran darah dalam
badan untuk menyediakan
darah beroksigen dan nutrien
kepada semua organ penting

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aliran darah tidak Aliran darah yang
beroksigen kembali membawa oksigen
ke jantung. dan nutrisi ke badan

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i. Kegagalan sistem kardiovaskular.
ii. Pengaliran cecair ke tisu tidak
mencukupi.
iii. Punca utama renjatan:-

kegagalan pam
kegagalan paip
kehilangan cecair
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Cardiogenic
Hemorrhagic
Neurogenic
Anaphylactic
Septic

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Cardiogenic shock

Jantung tidak berfungsi dengan baik

Menyebabkan darah masuk ke paru-paru

Known as congestive heart failure

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Clinical definition of cardiogenic shock is
decreased cardiac output and evidence of tissue
hypoxia in the presence of adequate intravascular
volume
Hemodynamic criteria are:
Sustained hypotension (systolic blood
pressure 90mm Hg for at least 30 minutes) and
A reduced cardiac index (92.2L/min per m2) in
the presence of elevated pulmonary capillary
occlusion pressure (15 mm Hg)
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Sebab:
i) Acute myocardial infarction
 Pump failure
 Mechanical complications
 Right ventricular infarction
ii) Severe depression of cardiac contractility
 Sepsis
 Myocarditis
 Myocardial contusion
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 Hemorrhage

 Tahap cecair yang berkurangan

 Kehilangan 2 pain darah atau lebih boleh

mengakibatkan renjatan

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2 jenis pendarahan

i. Pendarahan Luaran (External Bleeding)

 Boleh dilihat

 Salur darah pecah dan kerosakan permukaan kulit

ii. Pendarahan Dalaman (Internal Bleeding)

 Tidak kelihatan

 Kerosakan organ dalaman

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i. Direct pressure

ii. Bandage

iii. Pressure point

iv. Elevation

v. Haemostatic suture

vi. Vosoconstrictor drugs

vii. Embolization
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Di sebabkan pengembangan salur darah

Tekanan darah akan menurun dengan pantas

Jenis;-

Fainting / psyhogenic shock

Anaphylactic shock / extreme allergic reaction

Spinal shock / spinal cord injuries

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Anaphylaxis is a severe systemic hpersensitivity
reaction characterized by multisystem involvement,
which may include hypotension or airway
compromise.

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The ‘classic’ presentation of anaphylaxis

- Pruritus

- Cutaneous flushing

- Urticaria

Others symptoms fullness in the throat, anxiety, a sensation

of chest tightness, shortness of breath, and lighteadednesss.

As the cascade progresses, decreased level of

consciousness, respiratory distress, and circulatory collapse
may ensure SHOCK
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Dadah

Sengatan dan racun

Makanan

Environmental

Tranfusions

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Rawatan;

 Baringkan mangsa dengan posisi kaki di tinggikan

 Sekiranya mangsa mempunyai epinephrine auto-injector,

bantu mangsa menggunakannya

 Kawal dan awasi ABC

 Hantar ke hospital dengan segera

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Caused by acute spinal cord injury (complete or incomplete)
that distrupted symp. Outflow – resulting loss of sympathetic
tone

Lack of sym. Tone leads to decrease tissue perfussion and

initation of the shock response.

Hypotension

Bradycardia

Warm, dry skin (lost of ability to sweat)

Hypothermia (peripheral vasidilatation)

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Sepsis;

The systemic response to infection, manifested by two

or more of the following conditions as a result of
infection:-

 Suhu >38oC or <36oC

 Kadar jantung >90 beats/min

 Kadar pernafasan >20/min or PaCO2 <32 mmHg

 Sel darah putih >12 000/L, <4000/L, or >10%

immature (band) form. 23
Sepsis induced hypotension and hypoperfusion despite
adequate fluid resuscitation along with the presence of
perfusion abnormalities that may include, but are not
limited to:-

Lactic acidosis

Oliguria

or an acute alteration in mental status

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 Lemah
 Loya
 Dahaga
 Pening
 Anxiety
 Agitation
 Takut
 Restlessness or combativeness
 Muntah
 Menggeletar atau trembling
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Altered mental status

 Pernafasan laju dan cetek

 Nadi laju tetapi lemah
 Kulit pucat, sejuk, lembap dan Cyanosis
 Lackluster eyes and sluggish pupils

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 Aktif EMS
 Scene size-up
 Appropriate BSI precaution
 Initial assessment
 Control external bleeding
Administer oxygen
 Assist patient in lying down
 Maintain normal body temperature

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 Position patient
 Elevate lower extremities or
 Lay patient flat with face up
or
 Elevate head and shoulder
– breathing difficulty
 Jangan beri apa-apa makanan
atau minuman
 Pantau vital signs mangsa

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