Shock: Treatment, symptoms, advice and help
Shock is a life-threatening condition wherein the tissues in the body are deprived of oxygen and nutrients which are essential for the normal functioning of the cells. This ultimately leads to cellular death, progressing to damage of multiple organs and finally, to death.
There are different categories of shock depending upon the underlying cause such as cardiogenic shock, neurogenic shock, hypovolemic shock, septic shock, and anaphylactic shock.
Shock: Incidence, age and sex
The overall incidence of shock is unknown but it is estimated that about 7 percent of those with heart attacks suffer from a particular kind of shock.
Signs and symptoms of shock: Diagnosis
Low blood pressure is the key sign of shock. Some other symptoms may include rapid and shallow breathing, cold and clammy skin, rapid and feeble pulse, dizziness, and unexplained weakness.
Depending on specific cause and type of shock, one may have mental confusion, unresponsiveness, anxiety, low or no urine output, bluish discolouration of the nail bed and skin, sweating, or chest pain.
Causes and prevention of shock
Shock can be caused by any condition that reduces the blood flow to the body, such as a heart disorder (e.g. a heart attack or a heart failure) or low blood volume in the body as happens in the case of heavy bleeding or dehydration, heavy internal or external bleeding, persistent vomiting or diarrhoea. Other causes of shock include burns, changes in blood vessels (as with infection or severe allergic reactions) and certain medications that significantly reduce heart function or blood pressure. Spinal injuries are also known to cause shock.
One should try to prevent or minimise the conditions that may precipitate the chances of shock like falls, heart diseases, injuries, or dehydration. If already in shock, it is advisable to treat it as soon as possible so as to result in minimum damage to the person's vital organs (such as the kidney, liver, and brain). Early first aid and emergency medical help can save a life.
The complications of shock are serious and include loss of consciousness, coma, and finally death.
Shock is an emergency which requires immediate medical treatment or it may worsen very rapidly.
Depending on the type or the cause of the shock, treatment modalities will differ. In general, fluid resuscitation (i.e. giving large amount of fluids to raise the blood pressure quickly) is the first-line treatment for all types of shock. Medications like epinephrine, nor-epinephrine or dopamine can be administered along with the fluids in order to raise the patient's blood pressure and ensure blood flow to the vital organs.
Septic shock is treated by administering antibiotics, depending on the source and type of underlying infection. Anaphylactic shock is treated with certain medications like diphenhydramine, epinephrine, and steroids. Cardiogenic shock is treated by identifying and treating the underlying cause. Hypovolemic shock is treated with fluids (saline) in minor cases, but this type of shock generally requires blood transfusions, if severe. The underlying cause of the bleeding also needs to be identified and corrected. Neurogenic shock is the most difficult to treat because damage to the spinal cord is often irreversible. Besides fluids and monitoring, immobilization (preventing the spine from moving), anti-inflammatory medications such as steroids and sometimes, surgery may be required.