SHOCK

Definition, Types, Symptoms, First Aid

GROUP 6
1D - PH
SHOCK
• Also known as Circulatory Shock
• 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
• Deprivation of oxygen and allows build-up of waste
products
MAJOR AND MINOR TYPES
MAJOR MINOR

 Cardiogenic  Respiratory
 Hypovolemic  Hemorrhagic
 Anaphylactic  Metabolic
 Septic  Psychologic
 Neurogenic  Insulin
STAGES
STAGE I
• Compensated or Non-
Progressive
• Heart beats faster
• Blood vessels constrict a little
• Kidneys work to retain fluid
levels
• Little or no urine output to
maximize the blood flow to the
most important systems of the
body
• Few symptoms
• Proper treatment can completely
stop any progression
STAGE II STAGE III
• Body’s compensation • Longer period of circulatory
methods begin to fail insufficiency leads to permanent
damage to organs and tissues
• Brain experiences oxygen
like the heart, brain, kidneys and
deprivation, causing
liver
confusion and
disorientation • Systems shut down, brain cells
die, and the person dies
• Lack of oxygen to the heart
causes chest pain
• Can still be reversed
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  Profuse sweating, moist skin

 Bluish lips and fingernails  Rapid but weak pulse
 Chest pains  Shallow breathing
 Confusion  Unconsciousness
 Dizziness, lightheadedness,
or faintness
 Pale, cool, clammy skin
 Low or no urine output
MAJOR TYPES AND ITS CAUSES
Cardiogenic Shock
• Heart-related shock
• Heart attack, infection of the
heart sac, blood clot or fluid
retention caused by heart
failure
TYPES AND ITS CAUSES
Causes of Cardiogenic Shock:
1. Lack of oxygen damages the left ventricle (the main pumping chamber)
2. Damage to the right ventricle (sends blood to your lungs to receive oxygen)
hinders ability to pump blood to your lungs, depriving your body of adequate
oxygen
3. Inflammation of the heart muscle (myocarditis)
4. Infection of the heart valves (endocarditis)
5. Weakened heart from any cause
6. Drug overdose
7. Poisoning with substances
TYPES AND ITS CAUSES
Hypovolemic Shock
• Low blood volume-related
• Hemorrhage, internal
bleeding, pancreatitis, severe
dehydration, vomiting,
diarrhea, uncontrolled
diabetes, large areas of
severely-burned skin, or
extreme heat stress
TYPES AND ITS CAUSES
Causes of Hypovolemic Shock:
1. Bleeding from cuts or wounds
2. Bleeding from blunt traumatic injuries due to accidents or seizure
activity
3. Internal bleeding from the digestive tract or due to a ruptured
ectopic pregnancy
4. Decrease in blood volume like excessive or prolonged diarrhea,
severe burns, protracted and excessive vomiting, and excessive
sweating
TYPES AND ITS CAUSES
Anaphylactic Shock
• Allergy-related like food, drug or
venom
• Symptoms also include skin
reactions (including hives along
with itching, and flushed or pale
skin), a feeling of warmth,
sensation of a lump in your
throat, and constriction of the
airways and a swollen tongue or
throat (which can cause
wheezing and trouble breathing)
TYPES AND ITS CAUSES
Causes of Anaphylatic Shock/Common Anaphylaxis
Triggers:
1. Certain medications (especially
penicillin, sometimes aspirin, * Less common triggers include
ibuprofen and naproxen) latex, medications use in
2. IV contrast used in some x-ray anesthesia and exercise
imaging tests
3. Foods (peanuts, treenuts, wheat,
fish, shellfish, milk, eggs)
4. Insect stings (bees, yellow
jackets, wasps, hornets, fire
ants)
TYPES AND ITS CAUSES
Septic Shock
• Overwhelming infection, usually
bacterial, that weakens the heart
and affects every tissue as it
circulates in the bloodstream,
dropping blood pressure to
dangerously low levels by
widening blood vessels, causing
respiratory distress, liver and
kidney failure, and coma
• Toxic shock syndrome
TYPES AND ITS CAUSES
Causes of Septic Shock:
1. Abdominal or digestive system
infections
2. Lung infections like pneumonia,
bronchitis, or lower respiratory
tract infections
3. Urinary tract infections
4. Reproductive system infections
• People who have these are also
susceptible to septic shock:
 Major surgery or long-term
hospitalization
 Diabetes
 Injection drug use
 ICU patients that are already very
sick
 Exposure to invasive devices like
IV catheters or breathing tubes
TYPES AND ITS CAUSES
Neurogenic Shock
• Damage to the nervous system
such as a severed spine or a
brain injury, extreme pain, or a
disease that affects the nervous
system
• Other symptoms include
hypotension, bradycardia,
hypothermia, and blank stares
(for severe state)
TYPES AND ITS CAUSES
Causes of Neurogenic Shock:
1. Spinal cord injury
2. Injury or trauma to the spinal cord either blunt or
penetrating or which may be caused by a dislocation,
rotation and overextension or flexion of the cord
(e.g. sport injuries, accidents, stab and gunshot wounds)

3. Regional anesthesia that is improperly administered

4. Drugs and medications that can affect the autonomic
nervous system
TREATMENT
• Quickly diagnose the stage of shock.
• Try to stop the underlying cause.
• Keep the patient warm.
• Medical personnel will treat the effects.
• Do not move or turn a person over.
• Do not place a pillow under the person’s head.
• Do not wait to see if his symptoms improve or get worse.
• Do not give the person anything by mouth.
FIRST AID PROCEDURES
If the person vomits or drools:

 Turn the head to one side to prevent choking.

 If a spinal injury is suspected, “log roll” the person
instead.
TREATMENT FOR SPECIFIC CAUSES
GENERAL

• Tests (x-rays, blood tests, EKGs) will determine the cause

and severity.
• IV fluids are administered.
• Fluid resuscitation with an IV in the ambulance or
emergency room is the first-line treatment.
• Medications like epinephrine, norepinephrine, or dopamine
are added to the fluids
TREATMENT FOR SPECIFIC CAUSES
CARDIOGENIC
• For a patient with a heart attack
o Cardiac catheterization

• For a patient with congestive heart failure

o Medications

• For severe and prolonged cases

o Heart transplant
TREATMENT FOR SPECIFIC CAUSES
HYPOVOLEMIC
• Minor cases – fluids (saline)
• Major/Severe cases – blood transfusions

ANAPHYLACTIC
• Diphhenhydramine, epinephrine, steroid medications
methylprednisolone, and sometimes a H2-Blocker
TREATMENT FOR SPECIFIC CAUSES
SEPTIC
• Antibiotics
o Depends on the source and type of underlying infection

NEUROGENIC
• Damage to the spinal cord is often irreversible
• Immobilization
• Anti-inflammatory medicines (steroids, surgery)
QUIZ
1. Responsible for the highest number of deaths in ICUs in the US
A. Septic shock
B. Shock
C. Anaphylaxis
D. Food allergies

2. It causes tissue death

A. Shock
B. Gangrene
C. Blood clots
D. Tachycardia
QUIZ
3. Technical term for tissue death

4. Hormone released by the device Twinject

A. Serotonin
B. Epinephrine
C. Dopamine
D. Glutamate
QUIZ
5. Technical term for blood poisoning
A. Sepsis
B. Meningococcemia
C. Anaphylaxis
D. Septicemia

6. Treatment for shock

A. IV fluids
B. Epipen
C. Antibiotics
D. All of the above
QUIZ
7. Main cause of shock

8. Kind of shock that is caused by bees

A. None
B. Metabolic
C. Hypovolemic
D. Anaphylactic