Tbilisi State Medical University

Kakabadze Ann

2015

Shock - is a life-threatening condition that occurs when the body is not getting enough blood flow. Lack of blood flow means that the cells and organs do not get enough oxygen and nutrients to function properly. Multiple organs can suffer damage as a result. Shock requires immediate medical treatment and can get worse very rapidly. As many 1 in 5 people who suffer shock will die from it.

There are several types of shock:

• septic shock caused by bacteria

• anaphylactic shock caused by hypersensitivity or allergic reaction

• cardiogenic shock from heart damage

• hypovolemic shock from blood or fluid loss

• neurogenic shock from spinal cord trauma

• traumatic shock

Septic shock results from bacteria multiplying in the blood and releasing toxins. Common causes of this are pneumonia, urinary tract infections, skin infections (cellulitis), intra-abdominal infections (such as a ruptured appendix), and meningitis.

Anaphylactic shock is a type of severe hypersensitivity or allergic reaction. Causes include allergy to insect stings, medicines, or foods (nuts, berries, seafood), etc.

Cardiogenic shock happens when the heart is damaged and unable to supply sufficient blood to the body. This can be the end result of a heart attack or congestive heart failure.

Hypovolemic shock is caused by severe blood and fluid loss, such as from traumatic bodily injury, which makes the heart unable to pump enough blood to the body, or severe anemia where there is not enough blood to carry oxygen through the body.

Neurogenic shock is caused by spinal cord injury, usually as a result of a traumatic accident or injury.

Symptoms:

A person in shock has extremely low blood pressure. Depending on the specific cause and type of shock, symptoms will include one or more of the following:

Anxiety or agitation/restlessness

Bluish lips and fingernails

Chest pain

Confusion

Dizziness, lightheadedness, or faintness

Pale, cool, clammy skin

Low or no urine output

Profuse sweating, moist skin

Rapid but weak pulse

Shallow breathing

Unconsciousness

Hypovolemic shock, also known as hemorrhagic shock, is a life-threatening condition that results when you lose more than 20 percent (one-fifth) of your body’s blood or fluid supply. This severe fluid loss makes it impossible for the heart to pump a sufficient amount of blood to your body. Hypovolemic shock can lead to organ failure. This condition requires immediate emergency medical attention.

Hypovolemic shock results from significant and sudden blood or fluid losses within your body. Blood loss of this magnitude can occur because of:

• bleeding from cuts or wounds

• bleeding from blunt traumatic injuries due to accidents or seizure activity

• internal bleeding from the digestive tract or due to a ruptured ectopic pregnancy

In addition to actual blood loss, the loss of body fluids can cause a decrease in blood volume. This can occur in cases of:

• excessive or prolonged diarrhea

• severe burns

• protracted and excessive vomiting

• excessive sweating

What Are the Symptoms of Hypovolemic Shock?

The symptoms of hypovolemic shock vary with the severity of the fluid or blood loss. However, all symptoms of shock are life-threatening and need emergency medical treatment. Internal bleeding symptoms may be hard to recognize until the symptoms of shock appear, but external bleeding will be visible. Symptoms of hemorrhagic shock may not appear immediately. Older adults may not experience these symptoms until the shock progresses significantly.

Symptoms include:

anxietyblue lips and fingernailslow or no urine outputprofuse sweatingshallow breathingdizzinesslightheadednessconfusionchest painloss of consciousnesslow blood pressurerapid heart rateweak pulse

You suspect a person is in shock, call 911 or your local emergency number. Then immediately take the following steps:

Lay the person down and elevate the legs and feet slightly, unless you think this may cause pain or further injury.

Keep the person still and don't move him or her unless necessary.

Begin CPR if the person shows no signs of life, such as breathing, coughing or movement.

Loosen tight clothing and, if needed, cover the person with a blanket to prevent chilling.

Don't let the person eat or drink anything.

If the person vomits or begins bleeding from the mouth, turn him or

her onto a side to prevent choking, unless you suspect a spinal injury.

First Aid:

Treatment for shock depends on the cause. Tests will determine the cause and severity. Usually IV fluids are administered in addition to medications that raise blood pressure.

• Septic shock is treated with antibiotics and fluids.

• Anaphylactic shock is treated with diphenhydramine (Benadryl), epinephrine (an "Epi-pen"), and steroid medications (solu-medrol).

• Cardiogenic shock is treated by identifying and treating the underlying cause.

• Hypovolemic shock is treated with fluids (saline) in minor cases, and blood transfusions in severe cases.

• Neurogenic shock is the most difficult to treat as spinal cord damage is often irreversible. Immobilization, anti-inflammatories such as steroids and surgery are the main treatments.