Shock (thing)

There are three vascular and two nonvascular causes of shock.

Vascular causes are:

• Pump failure, i.e. the heart is damaged and cannot pump the blood effectively:
  Cardiogenic shock

• Blood/fluid loss, i.e. low volume in the circulatory system causing insufficient perfusion of the body:
  Hypovolemic shock; when due to blood loss, hemorrhagic shock; may result from trauma, burns, crush injuries or dehydration.
  Metabolic shock; due to severe untreated illness, such as diabetes, vomiting, diarrhea or excessive urination
  Septic shock; due to bacterial toxins from severe systemic infections, blood vessels become leaky and dilated, producing a combination of blood volume loss and vessel volume increase

• Dilation of the blood vessels, i.e. increase in the volume of the circulatory system resulting in proportionally less blood volume, causing insufficient perfusion of the body:
  Neurogenic shock; due to spinal cord damage, blood vessel tone below the level of injury is lost, causing general dilation of vessels and vessel volume increase
  Psychogenic shock; aka the common faint, is a temporary generalized dilation of the blood vessels due to some psychological (well, there's really no other word..) shock

Nonvascular causes are:

• Respiratory shock; due to severe chest injury or airway obstruction causing inadequate blood oxygen levels; enough blood is carried to the organs, but there is not enough oxygen in it

• Anaphylactic shock; the most severe form of allergic reaction, involving itching, flushing, hives, edema (especially of the face, lips and tongue), coughing, tightness in the chest, wheezing and dyspnea, drop in blood pressure, pallor, dizziness, fainting and coma. Anaphylactic shock is basically a type of respiratory shock, as the problems are mainly due to low blood oxygen

Symptoms of shock include:

• Restlessness and anxiety
• Rapid, weak pulse
• Cold, clammy skin
• Severe sweating
• Pallor, possibly late cyanosis (especially around the mouth)
• Shallow, rapid, labored breathing
• Dilated pupils
• Thirst
• Nausea and vomiting
• Dropping blood pressure
• Loss of consciousness

Initial treatment of shock should involve the following steps:

• Open the patient's airway and give oxygen, if possible
• Control obvious bleeding through direct pressure
• Elevate the lower extremities ca. 12 inches (if no obvious fractures are present)
• Avoid rough handling, avoid causing any unnecessary pain
• Prevent loss of body heat by placing blankets under and over the patient (do not overload)
• Keep patient lying down; if patient has difficulty breathing, allow patient to assume most comfortable position
• Do not give the patient anything by mouth - neither food or drink
• Obtain medical attention for the patient as soon as possible