Shock is a continuum of events that progresses through several stages, including compensated, decompensated or progressive, and irreversible shock.
The three phases of shock: Irreversible, compensated, and decompsated shock.
The shock syndrome is a pathway involving a variety of pathologic processes that may be categorized as four stages: initial, compensatory, progressive, and refractory (Urden, Stacy, & Lough, 2014).
They include the initial stage, the compensatory stage, the progressive stage, and the refractory stage.
Classically, there are four categories of shock: hypovolemic, cardiogenic, obstructive, and distributive shock.
In hypovolemic (or hemorrhagic) shock, administer 3 mL of fluid for every 1 mL of estimated blood lost—a 3:1 ratio. If fluid boluses do not improve the signs of hypovolemic, hemorrhagic shock, consider the administration of packed red blood cells without delay.
Primary shock, or collapse, refers to the condition in which a decline in the blood pressure and the appearance of the symptoms of shock are noted immediately following the injury. In secondary shock, the time interval separating the injury and the appearance of symptoms is usually an hour or more.
Managing shock
Raise the patient's legs (unless they have fractures or a snake bite) above the level of the heart, with head flat on the floor. Treat any wound or burn and immobilise fractures. Loosen tight clothing around neck, chest and waist. Maintain the patient's body warmth with a blanket or similar.
There are mainly four broad categories of shock: distributive, hypovolemic, cardiogenic, and obstructive. [1] The wide range of etiologies can contribute to each of these categories and are manifested by the final outcome of shock.
The initial stage of shock is characterized by hypoxia and anaerobic cell respiration leading to lactic acidosis. The compensatory stage is characterized by the employment of neural, hormonal, and biochemical mechanisms in the body's attempt to reverse the condition.
The patient is likely to be awake on the AVPU scale, but may have altered mental status like confusion, irritability or lethargy. Because the body is attempting to main critical systems, such as the brain, heart, liver and kidneys, you may notice changes in the patient's skin condition.
The treatment of shock includes the administration of endogenous catecholamines (epinephrine, norepinephrine, and dopamine) as well as various vaso-pressor agents that have shown efficacy in the treatment of the various types of shock.
A drop in blood pressure reduces the flow of oxygen and nutrients to a person's vital organs such as their brain, heart and lungs. If the blood flow is not restored, the person may die from complications due to lack of oxygen supply to major organs (hypoxia).
Shock requires emergency medical treatment. The first priority is to get blood pressure back up to normal. This may be done by giving blood and fluids through a vein. Blood-pressure-raising medicines may be administered.
What Is a Mild Electric Shock? A mild electric shock is one that doesn't cause any major symptoms or tissue damage. In general, currents of less than 50 volts are unlikely to cause major damage or death, but even low-voltage electrical circuits can cause injury in some situations.
Psychological shock is when you experience a surge of strong emotions and a corresponding physical reaction, in response to a (typically unexpected) stressful event.
Systolic hypotension, oliguria, metabolic acidosis and a cold clammy skin are late signs of shock.
Physical examination can show subtle changes like cool or pale extremities with delayed capillary refill, restlessness or agitation, narrow pulse pressure, or relative tachycardia.
People experience emotional shock for varying amounts of time. Depending on its severity and the circumstances, it may dissipate on its own within minutes or may persist for longer. It can lead to acute stress disorder (ASD) or post-traumatic stress disorder (PTSD).
Keep the person still and don't move the person unless necessary. Begin CPR if the person shows no signs of life, such as not breathing, coughing or moving. Loosen tight clothing and, if needed, cover the person with a blanket to prevent chilling. Don't let the person eat or drink anything.
The body goes into shock when it can't get enough blood to the vital organs like your heart or brain. This may be caused by a sudden illness, an injury, or bleeding. Sometimes even a mild injury will lead to shock. Shock is a life-threatening condition.
Rule of 30 refers to a 30% fall in hematocrit, a 30 mmHg fall in systolic blood pressure, an increase by 30 beats/min of pulse rate, a 30% fall of hemoglobin (approximately 3 g/dl), and an approximate blood loss of 30% of normal (70 ml/kg in adults; 100 ml/kg throughout pregnancy).
Systolic blood pressure is normal in early shock. In late (decompensated) shock, perfusion is profoundly affected. Signs include low blood pressure, tachypnea, cool/clammy skin, agitation, and altered mental status.