Definition
Shock is an emergency condition that occurs when the body does not get enough blood flow. The lack of blood flow will cause cells and organs to not get enough oxygen and nutrients to function properly. As a result, many organs can be damaged. Shock can be caused by any injury or condition that affects blood flow throughout your body.
It is a condition that can deteriorate rapidly, and lead to multiple organ failure and potentially life-threatening complications. It is estimated that as many as 1 in 5 people who experience shock will die. Therefore, immediate help is needed in the management of shock cases.
Causes
Shock is classified into several types based on the cause of the onset, including:
1. Septic Shock
This shock is caused by the proliferation of bacteria in the blood, as well as the toxins they release. Common causes of this type of shock are:
- Pneumonia (infection of the lungs)
- Urinary tract infection
- Skin infection (cellulitis)
- Infections of internal organs (such as a ruptured appendix)
- Meningitis (infection of the lining of the brain)
2. Neurogenic Shock
This type of shock is caused by a spinal injury, which is typically the result of an accident.
3. Anaphylactic Shock
This type of shock results from a severe and excessive allergic reaction. Allergies to insect stings, medications, or foods (nuts, berries, and seafood) are among the possible causes.
4. Cardiogenic Shock
This type of shock usually occurs when the heart is damaged and cannot pump enough blood throughout the body. This condition can be the final stage of a heart attack or congestive heart failure.
5. Hypovolemic Shock
This type of shock is caused by a large loss of blood and fluid, such as from a bodily injury, which prevents the heart from pumping enough blood to the body, or severe anemia, in which there is insufficient blood to transport oxygen throughout the body.
Shock itself is caused by reduced blood flow to tissues and organs. This can be caused by several conditions, including:
- Failure of oxygen distribution to body cells, such as:
- The amount of oxygen in the inhaled air is reduced
- Being at a high altitude
- Carbon monoxide poisoning, etc
- Pulmonary disorders that prevent the lungs from delivering oxygen to the bloodstream. Examples of causes include:
- Pneumonia (infection of the lungs)
- Congestive heart failure (the lungs fill with fluid or pulmonary edema)
- Injury that causes the lungs to bruise or collapse
- Pulmonary embolism (blockage of blood vessels in the lungs)
- A heart that cannot adequately pump blood to body tissues. Examples of causes include:
- A heart attack in which the heart muscle is damaged and the heart cannot beat strongly enough to pump blood into the rest of the body
- Heart rhythm disturbances
- Inflammation of the sac around the heart (pericarditis) or inflammation of the heart muscle due to infection or other causes, rendering the heart's ability to pump blood ineffective
- Anemia is a lack of red blood cells in the bloodstream. If there are not enough red blood cells, the body's tissues receive less oxygen. This condition may be caused by:
- Bleeding
- The inability of the bone marrow to make red blood cells
- Increased destruction of red blood cells by the body (for example, sickle cell disease)
- Lack of fluid in the blood vessels, for example in the case of:
- Dehydration due to loss of body fluids
- Central nervous system disorders in which blood vessels cannot maintain enough pressure within their walls to allow blood to be pumped around the body
Risk factor
The risk of shock increases if you have conditions such as:
- Severe allergic reaction
- Large amounts of blood loss
- Infection in the blood
- Dehydration
- Poisoning
- Burns
- Heart problems
- Injury to the spine
- Persistent vomiting or diarrhea
Symptoms
People in shock will have one or more of the following symptoms:
- Rapid, weak, or even no pulse
- Irregular heartbeat
- Chest pain
- Body temperature not within the normal range
- Rapid, short, and shallow breathing
- Dizziness
- Cold skin
- Bluish lips and nails
- Excessive sweating
- Nausea
- Confusion
- Anxiety
- Thirst and dry mouth
- Dilated pupils of the eyes
- Decreased amount of urine
- Low blood sugar
- Decreased consciousness
- Low blood pressure
- Seizures
Diagnosis
Shock is a medical emergency that requires prompt diagnosis and treatment. Doctors can usually tell when a patient is in shock based on their symptoms. The doctor can also check the patient's blood pressure, pulse, breathing rate, and temperature. The doctor will also ask about the patient's medical history and what happened before the patient fell into shock.
When shock is diagnosed, the doctor's priority is to provide life-saving treatment so that blood can circulate throughout the body as soon as possible. This can be accomplished by providing fluids, medications, blood components, and other forms of support.
The shock will not go away until doctors identify and treat the underlying cause. Once the patient's condition has stabilized, the doctor will investigate the cause of the shock. To do so, the doctor may suggest one or more tests, such as:
1. Imaging Test
The doctor may use imaging tests to look for injuries or damage to the internal tissues and organs, such as broken bones, ruptured internal organs, tears in muscles or tendons, and abnormal tissue growth in the body.
Imaging tests may include:
- Ultrasound
- X-rays
- CT-scan
- MRI
2. Blood Test
Blood tests can be used to check for:
- Significant blood loss
- Infection in the blood
- Use of certain medications or drug overdose
Management
Shock management must be initiated as soon as possible to avoid life-threatening complications. A person in shock should be taken to the emergency room (ER) to get medical attention. Because shock can occur for a variety of reasons, the treatment is determined by the cause.
- If the patient is in shock due to bleeding and has lost a significant amount of blood, as a first aid measure, apply pressure to the bleeding area with a towel or cloth while transporting the patient to the emergency room
- If the patient is losing fluid due to repeated vomiting or bleeding from the mouth, and there is no evidence of spinal cord injury, you can tilt the patient to avoid choking. Vomit or blood may enter the patient's airway, worsening their condition
- You can undo or loosen tight clothing, and if necessary, cover the patient with a blanket to keep them warm
- If you discover that someone is in shock and begins to show no signs of life, such as not breathing, unconscious, no pulse, or not moving, you can perform cardiopulmonary resuscitation (CPR)
Once medical assistance arrives, doctors will usually provide initial therapy, such as:
- Administering fluids through an IV
- Keeping the patient's body temperature stable
- Administration of medications to raise blood pressure and pulse rate
- Administering oxygen
- Insertion of a breathing apparatus if needed
- Administration of antibiotics in septic shock to overcome the infection
Complications
If shock is not treated promptly and appropriately, it can result in complications such as multiple organ failure, disability, and even death
Prevention
Some types and cases of shock are preventable. Take the following steps to lead a healthy lifestyle, such as:
- If you have been diagnosed with allergies, avoid the triggering factors and carry the antiallergic medication prescribed by your doctor. Use it at the first sign of an allergic reaction. If the allergy does not improve after taking the medication, you should immediately go to the emergency room for further treatment
- To reduce the risk of blood loss due to injury, always wear personal protective equipment when participating in physical activities such as riding a bicycle or operating dangerous machinery. Always use a seat belt when traveling in a motor vehicle
- To lower the chances of heart damage, eat a balanced diet, exercise regularly, and avoid smoking and second-hand smoke
- Stay hydrated by drinking plenty of fluids. This is especially important when you spend time in very hot or humid environments
When to see a doctor?
If you or your loved ones have risk factors such as allergies and are experiencing shock symptoms, go to the emergency room right away to get the proper treatment. Shock is a medical emergency that must be treated immediately.
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- dr Hanifa Rahma
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