SHOCK
Shock is a critical condition brought
on by the sudden drop in blood flow
through the body.
The body experiences shock when it
don’t have enough blood circulating
through the system to keep organs
and tissues functioning properly.
It can be caused by any injury or
condition that affects the flow of
blood through the body.
Shock can lead to multiple organ
failure as well as life-threatening
complications.
The four major types are:
obstructive shock
cardiogenic shock
distributive shock
hypovolemic shock
Obstructive shock
Obstructive shock occurs when blood can’t get
where it needs to go.
A pulmonary embolism is one condition that may
cause an interruption to blood flow.
Conditions that can cause a buildup of air or fluid in
the chest cavity can also lead to obstructive shock.
These include:
pneumothorax (collapsed lung)
hemothorax (blood collects in the space between the
chest wall and lung)
cardiac tamponade (blood or fluids fill the space
between the sac that surrounds the heart and the
heart muscle)
Cardiogenic shock
Damage to the heart can decrease
the blood flow to the body, leading
to cardiogenic shock.
Common causes of cardiogenic
shock include:
Damage to the heart muscle
Irregular heart rhythm
Very slow heart rhythm
Distributive shock
Conditions that cause the blood vessels to
lose their tone can cause distributive shock.
When the blood vessels lose their tone, they
can become so open and floppy that not
enough blood pressure supplies the organs.
Distributive shock can result in symptoms
including:
flushing
low blood pressure
loss of consciousness
Thereare a number of types of distributive
shock, including the following:
Anaphylactic shock is a complication of a
severe allergic reaction known as anaphylaxis.
Allergic reactions occur when your body
mistakenly treats a harmless substance as
harmful. This triggers a dangerous immune
response.
Anaphylaxis is usually caused by allergic
reactions to food, insect venom, medications,
or latex
Septic shock
is another form of distributive shock.
Sepsis, also known as blood poisoning, is a condition
caused by infections that lead to bacteria entering
your bloodstream.
Septic shock occurs when bacteria and their toxins
cause serious damage to tissues or organs in your
body.
Neurogenic shock
is caused by damage to the central nervous system,
usually a spinal cord injury.
This causes blood vessels to dilate, and the skin may
feel warm and flushed. The heart rate slows, and
blood pressure drops very low
Hypovolemic shock
Hypovolemic shock happens when there
isn’t enough blood in the blood vessels to
carry oxygen to the organs.
This can be caused by severe blood loss,
for example, from injuries.
The blood delivers oxygen and vital
nutrients to the organs.
If you lose too much blood, the organs
can’t function properly.
Serious dehydration can also cause this
type of shock
causes
severe allergic reaction
significant blood loss
heart failure
blood infections
dehydration
poisoning
burns
symptoms
rapid, weak, or absent pulse
irregular heartbeat
rapid, shallow breathing
lightheadedness
cool, clammy skin
dilated pupils
lackluster eyes
chest pain
nausea
confusion
anxiety
decrease in urine
thirst and dry mouth
low blood sugar
loss of consciousness
Diagnosis
Imaging tests
The doctor may order imaging
tests to check for injuries or
damage to the internal tissues
and organs, such as:
bone fractures
organ ruptures
muscle or tendon tears
abnormal growths
Such tests include:
ultrasound
X-ray
CT scan
MRI scan
Blood tests
The doctor may use blood tests to look for
signs of:
significant blood loss
infection in the blood
drug or medication overdose
Firstresponders and doctors
often recognize shock by its
external symptoms. They may
also check for:
low blood pressure
weak pulse
rapid heartbeat
Medical treatment
Septic shock is treated with
prompt administration of
antibiotics depending on the
source and type of underlying
infection.
These patients are often
dehydrated and require large
amounts of fluids to increase and
maintain blood pressure
Anaphylactic shock is treated
with diphenhydramine
(Benadryl), epinephrine (an "Epi-
pen"), steroid medications
methylprednisolone (Solu-
Medrol), and sometimes a H2-
Blocker medication (for example,
famotidine [Pepcid], cimetidine
[Tagamet], etc.)
Cardiogenic shock is treated by
identifying and treating the underlying
cause.
A patient with a heart attack may require
a surgical procedure called a cardiac
catheterization to unblock an artery.
A patient with congestive heart failure
may need medications to support and
increase the force of the heart's beat.
In severe or prolonged cases, a heart
transplant may be the only treatment.
Hypovolemic shock is treated
with fluids (saline) in minor cases,
but may require multiple blood
transfusions in severe cases. The
underlying cause of the bleeding
must also be identified and
corrected.
Neurogenic shock is the most difficult
to treat. Damage to the spinal cord is
often irreversible and causes
problems with the natural regulatory
functions of the body.
Besides fluids and monitoring,
immobilization (keeping the spine
from moving), anti-inflammatory
medicine such as steroids, and
sometimes surgery are the main parts
of treatment.
