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HAEMORRHAGE

AND

SHOCK

Presented by:-

Dr. Arjun Singh

(P.G.First year) Guided by:-

Dr. Sanjeev Kumar

(Professor and Head)

Dept. of Oral & Maxillofacial Surgery

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CONTENTS

Introduction

Definition

Classification

Stages of shock

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Definition

Shock is a life threatening situation. In

most cases it is due to poor tissue

perfusion with impaired cellularmetabolism, manifested in turn by

serious pathophysiological

abnormalities.Bailey and Love

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Shock may be defined as .an acutegeneralized, inadequate perfusion of

critical organs that, if continued, will

produce serious pathophysiological

consequences.

FONSECA

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Shock

is the clinical syndrome thatresults from inadequate tissue

perfusion. Irrespective of cause, the

hypoperfusion-induced imbalancebetween the delivery of and

requirements for oxygen and

substrate leads to cellular

dysfunction.

HARRISON

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Shock is a condition in which

circulation fails to meet thenutritional needs of the cells and

fails to remove the metabolic waste

products.

S. DAS

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I. Classification of shock(Somen Das)

Haematogenic or Hypovolaemic shock

Traumatic shockNeurogenic shock

Cardiogenic shock

Septic shock

Miscellaneous types

a) Anaphylacticshock

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II. Classification of shock (Harrison)

1) Hypovolaemic Shock

2) Traumatic shock

3) Cardiogenic shock

- Intrinsic

- Compressive

4) Septic

- Hyperdynamic

- Hypodynamic

5) Neurogenic shock

6) Hypoadrenal Shock

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1)Primary or Initial shock

Is a transient and usually benign vasovagal attack resulting

from sudden reduction of venous return to the heart caused by

neurogenic vasodilatation and consequent peripheral pooling

of the blood.

-It can occur immediately following

Trauma

Severe pain

Emotional overreaction due toa) Fear

b) Sorrow and surprise

c) Sight of blood

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Clinically Patient develops,signs andsymptoms similar to that of syncope

- Unconsciousness

- Weakness

- Sinking Sensation

- Pale and Clammy limbs

- Weak and rapid pulse and

- Low Blood Pressure

Primary shock can be labelled as a severe form

of syncope.Lasting few seconds to minutes.

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2) Secondary (or) True shock

occurs due to haemodynomicderangements with hypoperfusion of the

cells, this type of shock is the true shock.

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STAGES OF SHOCK

According to Winters, the different manifestations of

shock occurs in 3 stages, namely:

-Initial stage or Compensated shock (Non progressive)

-Decompensated shock (Progressive)

-Irreversible shock

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Initial stage or Compensatory stage or Non

progressing stage

Slight reduction in the circulation blood

volume. does not produce severe symptoms or

manifestations

Progression compensated by compensatory

mechanisms

Blood pressure and cardiac output maintained by

various negative feedback control mechanisms like ;