What is shock? Shock is a life-threatening emergency condition that occurs as a result of a sudden drop in blood flow to various organs and tissues. The lack of blood flow to these organs causes severe damages to the organs.
When there is less blood flow to the organs and tissues of our body, they malfunction because of deprivation of oxygen, which is carried by the blood to them. Oxygen carried by the blood to all organs and tissues in our bodies are the foods for the organs, so in the absence of this food (oxygen), they are malnourished (malfunctioned).
Without proper prompt management of shock, death is inevitable.
We at Mayor Boss did some research on the manifestations of shock and prepared this topic for our readers to understand the symptoms, types, and the treatment of shock. So without further delay, let’s dive right in.
What are the symptoms of shock?
Here are the signs and symptoms of shock:
- Cold, clammy, pale skin
- Rapid pulse (tachycardia)
- Nausea and vomiting
- Enlarged (dilated) pupils
- Weakness or fatigue (is an extreme weakness)
- Dizziness and feeling faint
- Increased thirst
- Profuse perspiration (sweating)
- Oliguria (reduced urine output). The normal amount of daily urine is 800ml to 2000ml
- Irregular breathing
- Altered mental state(confusion, disorientation)
- Hypotension (low blood pressure)
- Inability to control bowel movements is mainly seen specifically in neurogenic shock
What are the types of shock?
Shock is divided into five categories according to the cause, and they are namely: hypovolemic shock, septic shock, anaphylactic shock, cardiogenic shock, and neurogenic shock.
Hypovolemic shock is a shock that occurs as a result of the low volume of blood in the body due to:
- Massive dehydration (severe vomiting, chronic diarrhea, severe burns, and excessive perspiration).
- Severe gastrointestinal (GI) bleeding
- Severe anemia
- Massive bleeding from trauma (crushing trauma, stabbings, gunshot wounds)
- Ruptured ectopic pregnancy
- Endometriosis and PCOS
Septic Shock is as a result of sepsis. Sepsis is a life-threatening infectious process that occurs as a result of the immune system trying to fight an infection in the body. This fight causes the release of certain chemicals into the body that ends up fighting other organs of the body, which may lead to shock. The major infectious diseases that trigger sepsis are pneumonia, pyelonephritis, peritonitis, diverticulitis.
Anaphylactic shock is a result of hypersensitivity or allergic reactions such as a reaction to certain medications, foods, insect bites. The two major signs that distinguish anaphylactic shock from other shocks are hives (a red itchy swollen rash on the skin) and swollen or itchy lips and tongue.
Cardiogenic shock is the heart’s inability to pump blood to meet the body’s metabolic needs. It is commonly caused by Myocardial infarction (heart attack), congestive heart failure, endocarditis, and cardiomyopathy.
Neurogenic shock is a shock that occurs as a result of spinal cord trauma and traumatic brain injury. This disrupts the autonomic pathways within the spinal cord.
How is shock diagnosed?
Diagnostic Methods of Shock
- Physical examination (checking temperature of the skin, observing pupils, inspecting fingernails for any bluish discoloration which will indicate decrease oxygen saturation, observation of patient’s general state)
- Blood pressure measurements with a sphygmomanometer
- Electrocardiogram (ECG)
- Angiogram (cardiac catheterization)
- Full blood count
- Biochemical analysis
- Chest x-ray
- Urinalysis( color, content, concentration)
- 24-hour urine test to check the quantity
- Pulse oximetry (to check oxygen saturation)
Treatment of shock involves emergency management of symptoms, treatment of the cause, and future preventive measures.
Emergency management of shock symptoms:
- Fluid resuscitation for all types of a shock to correct hypoglycemia and hypotension
- Inotropic agents to raise blood pressure, such as dopamine or norepinephrine.
- Antiplatelet such as aspirin is given to reduce the formation of a blood clot in order to improve circulation
- Thrombolytic drugs such as Alteplase or streptokinase is given to dissolve already formed clot.
- Supplemental Oxygen
Treatment of shock cause
Hypovolemic shock: Fluid replacement in minor issues and blood transfusion in case of massive bleeds
Septic shock: antibiotics(penicillin)
Anaphylactic shock: Diphenhydramine(Benadryl), Epinephrine, H2- blockers( famotidine, cimetidine) and Steroids(methylprednisolone).
- Heart attack: cardiac catheterization with a stent to unblock the blocked artery.
- Congestive heart failure: drugs to increase the force of the heartbeat, for example, Digoxin
- Coronary artery bypass surgery.
- Heart transplant
- NSAIDs for pain and inflammation
- Anti-inflammatory drugs such as steroids
- Immobilization( to prevent unnecessary movements of the spine which may damage the spine further).
Shock is an emergency condition and should be handled with that in mind. Cardiogenic shock can be prevented by lifestyle modifications such as quitting smoking, avoid being a secondhand smoker, check your BP regularly, and maintain a healthy BMI. While septic shock can be prevented by good hygiene, taking vaccinations as recommended against infections such as pneumonia, flu, viruses.