Shock is a life-threatening condition in which blood flow to the organs is low, decreasing delivery of oxygen and thus causing organ damage and sometimes death. Blood pressure is usually low. Show
Multiple organ dysfunction syndrome (MODS) is the failure of two or more organs. This diagnosis carries a significant chance of death. People in shock require immediate emergency treatment and are usually cared for in the hospital intensive care unit. Although low blood pressure is generally the cause of shock, blood pressure may not be low in the early stages of shock. Also, blood pressure can be low in people who do not have shock. The medical disorder of shock has nothing to do with the “shock” that people feel from a sudden emotional stress. Shock has several causes: Low blood volume results in less-than-normal amounts of blood entering the heart with every heartbeat and therefore less-than-normal amounts of blood being pumped out to the body and its cells. Blood volume may be low because of
Blood may be rapidly lost because of
An excessive loss of body fluids other than blood can result from
Fluid intake may be inadequate because a physical disability (such as severe joint disease) or a mental disability (such as Alzheimer disease) may prevent people from obtaining enough fluids even though they may feel thirsty. Inadequate pumping action of the heart can also result in less-than-normal amounts of blood being pumped out with every heartbeat. The most common causes of inadequate pumping action are Excessive dilation of blood vessels (vasodilation) increases the capacity of blood vessels and decreases blood pressure. This can decrease blood flow and oxygen delivery to organs. Blood vessels may be excessively dilated because of
The mechanisms by which these conditions cause vasodilation vary. For example, a spinal cord injury interrupts the nerves from the brain to the blood vessels that normally cause blood vessel constriction; poisons or toxins released by bacteria can directly cause the blood vessels to dilate. Symptoms of shock are similar when the cause is low blood volume or inadequate pumping action of the heart.
When shock results from excessive dilation of blood vessels, the symptoms are somewhat different. The skin may be warm and flushed, and the pulse may be strong and forceful (bounding) rather than weak, particularly at first. However, later on, shock due to excessive dilation of blood vessels also produces cold, clammy skin and lethargy.
The diagnosis of shock is based mainly on evidence of organ malfunction found on a doctor's evaluation. For example, people
People may also show signs of trying to compensate for their low blood volume or their heart's inadequate pumping. For example, they may have a rapid heart rate, be breathing rapidly, or be perspiring profusely. Blood tests can help the diagnosis, but no finding alone is diagnostic, and doctors evaluate each by its trend (ie, worsening or improving) and in light of the person's overall condition. One blood test (the level of lactate) measures the amount of waste products of cellular activity in the blood. An elevated blood lactate level suggests to the doctor that the organs are not receiving enough oxygen and blood and that the person may have shock. Blood tests may also indicate damage to specific organs. For example, a high level of creatinine can indicate that the kidneys are damaged, and a high level of troponin (a cardiac biomarker) can indicate that the heart is damaged. Other tests are done depending on the probable cause of shock. For example, doctors do cultures of blood and other body fluids Culture of Microorganisms Infectious diseases are caused by microorganisms, such as bacteria, viruses, fungi, and parasites. Doctors suspect an infection based on the person's symptoms, physical examination results,... read more if they suspect severe infection. They may do electrocardiography Electrocardiography Electrocardiography (ECG) is a quick, simple, painless procedure in which the heart’s electrical impulses are amplified and recorded. This record, the electrocardiogram (also known as an ECG)... read more and other cardiac imaging tests Diagnosis of Heart and Blood Vessel Disorders if the person has signs of heart problems. Untreated shock is usually fatal. If shock is treated, the outlook depends on the
Multiple organ dysfunction syndrome carries a significant risk of death. The risk of death increases as the number of affected organs increases. Regardless of treatment, the likelihood of death due to shock after a massive heart attack or due to septic shock, especially in older people, is high.
Most important is to call for help and stop any major bleeding. After doing that, the person can be laid down and kept warm, with the legs elevated. When emergency medical personnel arrive, they may provide oxygen through a face mask or insert a breathing tube. Fluids may be given by vein (intravenously) at a fast rate and in large volumes to raise blood pressure. If shock is caused by severe infection, doctors give intravenous fluids and antibiotics. If shock is caused by a heart attack or other heart problem, other procedures or surgery may be needed. For some types of shock, drugs may be given intravenously to increase blood pressure. However, doctors use such drugs for as brief a time as possible because they can reduce blood flow to other tissues in the body or cause heart rhythm problems. Drugs can increase blood pressure by
Fluids given intravenously, blood transfusions, and drugs may not be enough to counteract shock if bleeding or fluid loss continues or if shock is caused by a heart attack, infection, or another problem unrelated to blood volume. Treating the cause of shock is vital. Which of the following is the best indicator of shock in a trauma patient?(e) Metabolic acidosis, indicating anaerobic metabolism, is the best indicator of shock. 5.
Which of the following may be the first indicator of shock in a trauma patient Phtls?The volume of patients studied in this paper clearly indicates that altered mental status is the first sign of shock. PHTLS and advanced trauma life support (ATLS) both look at GCS scores and vital sign numbers as the signs we should be using to evaluate our patients.
What are the early indicators of shock?Common signs and symptoms of shock include: Low blood pressure. Altered mental state, including reduced alertness and awareness, confusion, and sleepiness. Cold, moist skin.
What is the most common cause of shock in trauma patients?In the setting of trauma, loss of circulating blood volume from hemorrhage is the most common cause of shock.
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