Shock
SHOCK
Shock is a life-threatening condition that occurs when there is a disruption in circulation, during which oxygen is not adequately delivered to tissues and waste products are not effectively removed. If circulation is disrupted, insufficient oxygen reaches vital organs such as the brain and heart.
Classification and Causes
Classification of shock:
• Cardiogenic (caused by heart disease).
• Hypovolemic (due to inadequate blood volume).
• Septic (caused by infection).
• Anaphylactic (due to an allergic reaction).
• Neurogenic (caused by nervous system damage).
The most common cause of shock is significant blood loss. Shock occurs when more than 1.2 liters of blood is lost (which is more than one quarter of the normal blood volume). This amount of blood loss can occur due to injuries, internal organ damage, bleeding into body cavities, or from ruptured blood vessels. Shock can also occur from loss of other body fluids, such as through vomiting, diarrhea, intestinal obstruction, or severe burns.
Shock can also occur when there is sufficient fluid but the heart is unable to pump blood. This can happen with severe heart disease, cardiac arrest, or acute heart failure.
Other causes of shock include severe infection, certain hormone deficiencies, low blood glucose levels (hypoglycemia), hypothermia, severe allergic reactions (anaphylactic shock), drug overdose, and spinal cord injury.
Recognition
In the beginning:
• Rapid pulse;
• Pale, cold skin; sweating.
As shock worsens:
• Bluish-gray skin, especially on the inner surface of the lips. When pressing and releasing the nail bed or earlobe, the color does not return quickly;
• Weakness and dizziness;
• Nausea, possibly vomiting;
• Thirst;
• Rapid and shallow breathing;
• Weak “thread-like” pulse (the pulse at the wrist disappears when about half of the blood volume is lost).
When the brain is deprived of oxygen, symptoms include:
• Restlessness and aggressiveness;
• Yawning and gasping (“air hunger”);
• Loss of consciousness.
Ultimately, heart function ceases.
First Aid
Objectives:
1. Recognize signs of shock.
2. Treat the suspected cause of shock.
3. Improve circulation to the brain, heart, and lungs.
4. Arrange for immediate transportation to the hospital.
Actions
1. Treat the possible cause of shock (e.g., severe bleeding, severe burns).
2. Lay the victim on a blanket to protect from cold ground or floors. Reassure them.
3. If the victim has not experienced trauma (no head, neck, spinal injuries), elevate and support the victim’s legs to improve blood flow to vital organs. If a fracture is suspected, immobilize.
Elevate the victim’s legs so that they are higher than the heart.
4. Loosen or cut clothing around the neck, chest, and waist to keep these areas free.
5. Cover the victim’s body and legs.
6. Call emergency medical services at 112.
7. If the victim is vomiting or drooling, turn their head to the side to prevent choking. If you suspect or detect a spinal injury, turn the victim as a whole (the head, neck, and back should be in a straight line).
8. Monitor and record vital functions: consciousness, pulse, and breathing. Measure the pulse at the wrist. If the victim loses consciousness, open the airway and check for breathing. Be prepared to perform chest compressions and rescue breaths if necessary.
Risks and Notes
• Do not allow the victim to eat, drink, smoke, or move. If they complain of thirst, moisten their lips with a small amount of water.
• Do not leave the victim unattended, especially when calling for help.
• Do not attempt to warm them with hot water or other direct heat sources.