SHOCK

Objectives
At the end of the lesson/discussion, each
learner should be able to:
 Define shock
 Outline the types of shock.
 Describe treatment of all types of shock
INTRODUCTION
 Shock is a life-threatening condition of circulatory
failure, causing inadequate oxygen delivery to meet
cellular metabolic needs and oxygen consumption
requirements, producing cellular and tissue
hypoxia. The effects of shock are initially reversible,
but rapidly become irreversible, resulting in
multiorgan failure (MOF) and death. When a patient
presents with undifferentiated shock, it is important
that the clinician immediately initiate therapy while
rapidly identifying the etiology so that definitive
therapy can be administered to reverse shock and
prevent MOF and death.
DEFINITION OF SHOCK
 Shock is defined as a state of cellular and tissue hypoxia
due to either reduced oxygen delivery, increased oxygen
consumption, inadequate oxygen utilization, or a
combination of these processes. This most commonly
occurs when there is circulatory failure manifested as
hypotension (ie, reduced tissue perfusion); however, it is
crucial to recognize that a patient in shock can present
hypertensive, normotensive, or hypotensive. Shock is
initially reversible, but must be recognized and treated
immediately to prevent progression to irreversible organ
dysfunction. "Undifferentiated shock" refers to the
situation where shock is recognized but the cause is
unclear.
First aid treatment for shock
 Treat any cause (e.g. attempt to stop bleeding)
 Constantly reassure the casualty
 Lay casualty down on a blanket and raise legs to help keep
blood in core
 Keep the casualty warm
 Loosen any tight clothing around the neck, chest, and waist
to make sure it doesn’t constrict their blood flow
 Check for breathing and circulation
 Check blood pressure if possible
 Start CPR if necessary
 Place the person in the shock position
 Do not move the person
 Provide basic first aid to visible injuries
1. ANAPHYLACTIC SHOCK

 Anaphylactic Shock refers to a severe and

life-threatening allergic reaction. It can occur
as a result of eating particular foods, taking
certain medications, or an insect bite.
Symptoms occur within 15 minutes of
exposure, so it’s crucial to be familiar with
them.
Symptoms of Anaphylactic Shock ( Minor)

 Itchy skin
 Dizziness
 Coughing
 Sneezing
 Breaking out in hives
 Laboured breathing
 Rapid heartbeat
 Wheezing
 Vomiting
Symptoms of Anaphylactic Shock
( severe)
 Difficult or noisy breathing
 Swelling of the tongue
 Swelling or tightness in throat
 Wheezing or persistent cough
 Difficulty in speaking
 Persistent dizziness or collapse
 Pale and floppy ( young children)
TREATMENT OF ANAPHYLACTIC
SHOCK (minor)
 The best way to prevent Anaphylactic Shock
is to know and avoid its triggers.
 The next best thing is to carry antihistamines

or Epinephrine and use when there is an

anaphylactic shock.
 If its an insect allergy remove the sting if

visible.
TREATMENT OF ANAPHYLACTIC
SHOCK (severe)
 If unconscious then place the casualty in
recovery position.
 If breathing is difficult allow them to sit with

legs stretched.
 Give epinephrine
2. HYPOVOLEMIC SHOCK

 Hypovolemic Shock is what happens to the body when a

person loses too much blood. As a result, the heart is unable
to pump enough blood to reach the organs, which can lead
to organ failure. It’s often the consequence of severe cuts,
traumatic injuries, internal bleeding, or endometriosis.
 Left untreated, the patient may suffer from brain damage or
death. Call for medical emergency assistance immediately.
Make sure the patient is lying down, with their feet elevated.
Do not elevate their head. Use a tourniquet to prevent
additional blood loss.
 Once the patient receives medical attention, they will need a
blood transfusion and medication to assist the heart in
pumping blood to all organs.
SYMPTOMS OF HYPOVOLEMIC SHOCK

 Headache
 Chest pain
 Dizziness
 Nausea
 Pale skin
 Shallow breathing
 Confusion
 Blue lips
 Blue fingernails
 Blood in urine
 Blood in the stool
 Abdominal swelling
 Vomiting blood
TREATMENT OF HYPOVOLAMIC
SHOCK
 Keep the person comfortable and warm to
avoid hypothermia.
 Have the person lie flat with the feet lifted

above the heart to increase circulation.

 Do not give fluids by mouth.
 Replace blood and fluids by intravenous

blood, blood products and or fluids.

3. SEPTIC SHOCK
 When a person has an infection, the immune system sends it’s special
cells into the blood to fight it. The process causes inflammation and can
lower blood pressure. If the blood pressure drops too low, the organs may
not receive enough oxygen and blood flow, causing the patient to go into
septic shock. This is potentially life-threatening.
 Pregnant women, babies, senior citizens, and people with a compromised

immune system are more likely to experience Septic Shock as a result of

infection.
Symptoms of Septic Shock
 Dizziness

 Slurred speech
 Shortness of breath
 Vomiting
 Severe muscular pain
 Disorientation
 Diarrhea
 Loss of consciousness
TREATMENT
 Septic Shock should be treated immediately.
Treatment options can include intravenous
fluids, oxygen therapy, antibiotics, or in a
severe situation, surgery to remove the
source of infection.
4. NEUROGENIC SHOCK

 Neurogenic Shock occurs when there’s an

uneven blood distribution throughout the body.
It’s often the result of a severe injury to the
central nervous system, a spinal injury, or
damage to the brain. Left untreated, it can cause
permanent damage to organs or even death.
 Some of the most common causes for
Neurogenic Shock include car accidents, gunshot
wounds, sports injuries, or improper
administration of anesthesia to the spinal cord.
SYMPTOMS OF NEUROGENIC SHOCK

 Chest pain
 Weak pulse
 Discolored lips
 Hypothermia
 Blank stares
 Dizziness
 Fainting
Treatment includes immobilizing the patient to
prevent further injury, intravenous fluids, and
medication to increase blood pressure.
5. CARDIOGENIC SHOCK

 Cardiogenic Shock occurs when the heart is

damaged and can’t pump blood adequately.
It’s often the result of a heart attack. This can
lead to organ failure. Although rare, it’s very
difficult to survive Cardiogenic Shock.
SYMPTOMS OF CARDIOGENIC SHOCK
 Tachycardia
 Shortness of breath
 Weak pulse
 Pale skin
 Cold hands
 Sweating
 Loss of consciousness
 Because it is generally the consequence of a heart attack, it’s
important to know the symptoms:
 Chest pressure
 Shoulder pain
 Pain along the jawline
 Shortness of breath
 Lightheadedness
 Nausea
TREATMENT
Emergency life support
 Most people who have cardiogenic shock need

extra oxygen. If necessary, you'll be connected

to a breathing machine (ventilator). You'll receive
medications and fluid through an IV line in your
arm.
Medications
 Fluids and plasma are given through an IV.

Medications to treat cardiogenic shock are given

to increase your heart's pumping ability and
reduce the risk of blood clots.