Physiologic shock is when you don’t have enough blood to support your organs and tissues. Psychologic shock is usually related to trauma. Show
What is shock? The term “shock” may refer to a psychologic or a physiologic type of shock. Psychologic shock is caused by a traumatic event and is also known as acute stress disorder. This type of shock causes a strong emotional response and may cause physical responses as well. The focus of this article is on the multiple causes of physiologic shock. Your body experiences shock when you don’t have enough blood circulating through your system to keep organs and tissues functioning properly. It can be caused by any injury or condition that affects the flow of blood through your body. Shock can lead to multiple organ failure as well as life-threatening complications. There are many types of shock. They fall under four main categories, based on what has affected the flow of blood. The four major types are:
All forms of shock are life-threatening. If you develop symptoms of shock, get medical help immediately. If you go into shock, you may experience one or more of the following:
Anything that affects the flow of blood through your body can cause shock. Some causes of shock include:
There are four major types of shock, each of which can be caused by a number of different events. Obstructive shockObstructive 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:
Cardiogenic shockDamage to your heart can decrease the blood flow to your body, leading to cardiogenic shock. Common causes of cardiogenic shock include:
Distributive shockConditions that cause your blood vessels to lose their tone can cause distributive shock. When your blood vessels lose their tone, they can become so open and floppy that not enough blood pressure supplies your organs. Distributive shock can result in symptoms including:
There are 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. Drug toxicities and brain injuries can also lead to distributive shock. Hypovolemic shockHypovolemic shock happens when there isn’t enough blood in your blood vessels to carry oxygen to your organs. This can be caused by severe blood loss, for example, from injuries. Your blood delivers oxygen and vital nutrients to your organs. If you lose too much blood, your organs can’t function properly. Serious dehydration can also cause this type of shock. First responders and doctors often recognize shock by its external symptoms. They may also check for:
Once they’ve diagnosed shock, their first priority is to provide lifesaving treatment to get blood circulating through the body as quickly as possible. This can be done by giving fluid, drugs, blood products, and supportive care. It won’t resolve unless they can find and treat the cause. Once you’re stable, your doctor can try to diagnose the cause of shock. To do so, they may order one or more tests, such as imaging or blood tests. Imaging testsYour doctor may order imaging tests to check for injuries or damage to your internal tissues and organs, such as:
Such tests include:
Blood testsYour doctor may use blood tests to look for signs of:
Shock can lead to unconsciousness, breathing problems, and even cardiac arrest:
First aid treatmentIf you suspect someone has gone into shock, call 911. Then follow these steps:
If they’re breathing:
If you suspect the person has injured their head, neck, or back, avoid moving them. Apply first aid to any visible wounds. If you suspect the person is experiencing an allergic reaction, ask them if they have an epinephrine auto-injector (EpiPen). People with severe allergies often carry this device. It contains an easy-to-inject needle with a dose of hormone called epinephrine. You can use it to treat anaphylaxis. If they begin to vomit, turn their head sideways. This helps prevent choking. If you suspect they’ve injured their neck or back, avoid turning their head. Instead, stabilize their neck and roll their entire body to the side to clear the vomit out. Medical careYour doctor’s treatment plan for shock will depend on the cause of your condition. Different types of shock are treated differently. For example, your doctor may use:
It’s possible to fully recover from shock. But if it isn’t treated quickly enough, shock can lead to permanent organ damage, disability, and even death. It’s critical to call 911 immediately if you suspect that you or someone you’re with is experiencing shock. Your chances of recovery and long-term outlook depend on many factors, including:
Some forms and cases of shock are preventable. Take steps to lead a safe and healthy lifestyle. For example:
Stay hydrated by drinking plenty of fluids. This is especially important when you’re spending time in very hot or humid environments. How does septic shock differ from hypovolemic shock?Hypovolemic shock happens when you lose a lot of blood or fluids. Causes include internal or external bleeding, dehydration, burns, and severe vomiting and/or diarrhea. Septic shock is caused by infections in the bloodstream. A severe allergic reaction can cause anaphylactic shock.
What is the drug of choice for severe septic shock?Epinephrine clearly increases MAP in patients unresponsive to other vasopressors, mainly by virtue of its potent inotropic effects on the heart; thus, it should probably be the first alternative agent considered in patients with septic shock who show a poor clinical response to norepinephrine or dopamine.
What is the firstInternational guidelines recommend dopamine or norepinephrine as first-line vasopressor agents in septic shock. Phenylephrine, epinephrine, vasopressin and terlipressin are considered second-line agents.
Which of the following class of drugs are used for the treatment of shock with hypovolemia?Medicines such as epinephrine or norepinephrine may be needed to increase blood pressure and the amount of blood pumped out of the heart (cardiac output).
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