today's topic is shock
is a medical condition that arises when
the tissues in the body do not receive
sufficient blood flow as a result of
problems with the circulatory system
lack of blood flow means a lack of
oxygen and nutrients to allow the cells
in the body to function properly
medical shock is a medical emergency and
requires immediate treatment as systems
can worsen rapidly treating shock
immediately can be life-saving medical
shock is totally different from an
emotional or psychological shock that
can occur from a traumatic or
frightening emotional event
there were four stages of shock initial
stage a compensatory stage Progressive
stage and the refractory stage
at the initial stage cells begin to
change as a result of perfusion and
oxygenation perfusion refers to the
process by which the veins deliver blood
to the capillary beds within the body
tissues this further results in the
cells using anaerobic without oxygen
metabolism to function instead of the
aerobic with oxygen metabolism lactic
acid and pyruvic acid are formed as a
byproduct of anaerobic metabolism this
initial stage of shock is reversible but
does not show any obvious symptom that
would signal that the body is entering a
stage of shock
during the compensatory stage the body
employs physiological mechanisms
including a neural hormonal and
biochemical mechanism to reverse the
result of the initial stage
hyperventilation is one of these
mechanisms during hyperventilation there
is an increased rate of breathing which
improves oxygen flow to the cells this
helps to neutralize the acidic condition
and raise the pH of the blood another
mechanism used by the body is referred
to as the catecholamine response
catecholamines are hormones that are
released by the adrenal gland and are
triggered by low blood pressure caused
by the reduced volume of blood flow
these hormones aim to increase the heart
rate in order to increase blood pressure
the rayon Angiotensin response is
another mechanism used by the body
during the response vasopressin is
released into the bloodstream to help
conserve fluid via the kidneys and
triggers vasoconstruction of the kidneys
GI tract and other organs to divert
blood to the heart lungs and brain as
anaerobic mechanism continues the body's
metabolic acidosis increases cellular
function deteriorates and the
compensatory mechanism begins to fail
and is not able to maintain the balance
needed to protect the organs
during the refractory stage the body
enters the last stage of shock the
organs fail and death may follow
causes the underlying cause has been
divided into four main parts the
cardiogenic shock which may be due to
damage to the heart from myocardial
infarction dysrhythmias congestive heart
failure cardiomyopathy or valvular heart
disease
hypovolemic shock is the most common
type and results from severe external or
internal bleeding dehydration kidney
failure inflammation of the pancreas
extensive Burns or diabetes insipidus
the distributive shock which may include
septic shock caused by bacteria such as
escherichia coli Proteus species
klepsiella and ammonia anaphylactic
shock caused by reactions to allergens
antigen drug or foreign protein that
causes the release of histamine the
neurogenic shock that occurs from high
spinal cord injuries or trauma the
obstructive shock that may result from
conditions such as tension pneumothorax
aortic stenosis and Pulmonary embolism
symptoms pale skin rapid pulse rapid
breathing weakness or fatigue dizziness
nausea or vomiting enlarged pupils cool
clammy skin
thirst and dry mouth feeling anxious
agitated or confused profuse sweating
diagnosis and treatment
diagnosis is generally based on a
combination of symptoms physical
examination and laboratory tests x-ray
blood tests EKGs to determine the
underlying cause of the shock and the
severity of your illness
treatment treatment is based on the
underlying cause
the first course of action is to give
fluid resuscitation this means that a
large amount of water is given with an
IV whether in an ambulance or emergency
room to raise the blood pressure
medications such as epinephrine dopamine
may be administered along with the fluid
to try to raise blood pressure and
ensure blood flows to the vital organs
treatment may also include securing the
airway if necessary to decrease the work
of breathing and to guard against
respiratory arrest
septic shock is treated with quick
administration of antibiotics depending
on the source and type of the infection
causing the shock in minor cases
hypovolic shock is treated with fluids
but may require multiple blood
transfusions in severe cases
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