Shock and Types of Shock ! - Public Health Notes

Table of Contents

What is a Shock?

Shock is a perilous state i.e. carried on by an unexpected drop in blood circulation through the body.
Shock is a state in which there is not enough blood flow to the tissues of the body as a result of problems in the circulatory system. i.e. there is not enough blood circulating in the system.
During shock, the blood system fails to sustain sufficient blood flow, abruptly limiting the supply of oxygen and nutrients to a vital body part.
Therefore, shock is a condition characterized by impaired cellular function as a result of reducing in the effective circulating blood valve resulting in an inadequate supply of oxygen and nutrients to the cells, tissues and organs.
Shock can be because of a number of diverse mechanisms, with insufficient blood volume and insufficient production of blood through the heart.
If untreated, shock may lead to permanent organ damage or even death.

Causes of Shock:

Trauma
Heatstroke
Blood loss
Allergic reactions
Severe infections
Poisoning
Severe burns etc.

Symptoms of Shock:

Low blood pressure
Bluish tinge to lips or fingernails
Rapid breathing
Cold and clammy skin
Rapid, weak pulse
Nausea or vomiting
Dizziness and fainting
Enlarged pupils

Types of Shock (CHAIN):

Basically there are five different types of shock which can be remembered as ‘CHAIN’. They are:

Cardiogenic shock (C)- due to heart problems
Hypovolemic shock (H)- caused by too little blood volume
Anaphylactic shock (A)- caused by allergic reactions
Septic shock/infectious shock (I)- due to infections
Neurogenic shock (N)- caused by damage to nervous system

1. Cardiogenic shock:

Cardiogenic shock is a shock which takes place when the heart is damaged so much that it is not able to supply enough blood to the organs of the body.
This is caused by pump failure (cardiac) as a result of acute myocardial infarction, tension, pneumothorax, acute arrythmias, cardiomyopathy etc.

Causes of Cardiogenic Shock:

Serious heart condition like Myocardial infarction, else identified as a heart attack.
Other complications may also include:
- Heart muscle not functioning/moving properly
- Rupture of the heart muscle
- Rupture of the walls or tissues of the heart
- Blockage in the heart

Symptoms of Cardiogenic Shock:

Chest pain
Increased heart rate
Fast breathing
Little or no urination
Heavy sweating, moist skin
Lightheadedness
Unconsciousness
Restlessness, agitation, confusion
Shortness of breath
Skin that feels cool to the touch
Weak pulse

First Aid Measures for Cardiogenic Shock:

Call local emergency help number instantly
Observe the symptoms
Place the victim flat on their back with feet raised up, except that intensifies the injury
Run CPR, if the victim has trouble inhalation
Untie outfits
Cover the victim with a blanket
Do not provide a few fluids or food
If the victim seems to be losing cognizance, turn victim over to the side to dodge choking on vomit.

2. Hypovolemic Shock (caused by too little blood volume):

It occurs as a result of reduction in the circulatory blood volume.
It occurs while the body drops 20% or further of its blood supply, which usually happens when injury or accident takes place.
It is very common cause of morbidity and mortality.

Causes of Hypovolemic Shock:

External bleeding: trauma, during operations, hematemesis (blood in vomit), hematuria (blood in urine) etc.
Internal bleeding: blunt abdominal injuries, ruptured ectopic pregnancies, fracture of long bones etc.
Severe dehydration
Loss of plasma fluids: from the burn wounds.

Symptoms of Hypovolemic Shock:

Anxiety
Weakness
Prolific bleeding
Sweating
Dizziness
Confusion and speedy/low breathing
Unconsciousness
If the hemorrhage is interior, symptoms might also consist of dark, tarry stools, stomach pain, and spewing blood.

First Aid Measures for Hypovolemic Shock:

Call emergency number instantly if a person is experiencing shock symptoms.
Have the victim lie even through their feet raised about 12 inches.
Do not elevate the head. Keep the head in 15-20 degrees low position in order to increase blood supply to the brain.
Abstain from moving the victim if a head, neck, or back damage is assumed.
Control further blood loss.
Breathing should be established.
Retain the victim warm to evade hypothermia
Do not give the victim liquids via the mouth.
Take out any noticeable dirt or debris from the wounded place. Do not take out rooted object jammed in the wound. Apply compression to the area with the help of a clean cloth.

3. Anaphylactic Shock (caused by allergic reaction):

Anaphylactic shock is an allergic response to antigen.
It is initiated by an allergic reaction.
It occurs after parental injection of an antigen. E.g.: drugs, penicillin, snake venom, insect stings etc.
Common triggers are medicines such as penicillin, latex, bee stings, and foods for instance nuts or shellfish.

Causes of Anaphylactic Shock:

Drug allergies
Food allergies
Snake bites
Insect bites/stings

Symptoms of Anaphylactic Shock:

Anxiety
Chest discomfort of tightness
Low blood pressure
Difficulty in breathing, coughing and wheezing
Restrained airway
Difficulty swallowing
Swollen tongue or lips
Tingling extremes
Nasal congestion
Hives, itchiness and redness of skin
Confusion and dizziness
Unconsciousness

First Aid Measures for Anaphylactic shock:

Instantly call the medical emergency number.
Rapidly assess the severity of symptoms
Reduce further absorption
For any injection or stings, apply a firm tourniquet proximal to the site
If he/she has any food in the mouth, remove the food from the mouth
Examine the person if he or she is carrying an epinephrine auto-injector to suppress an allergic occurrence.
If the person states he or she requires using an auto-injector, question whether aider must help to inject the medication as it is generally done by pressing the auto-injector against the victim’s thigh.
Let the victim lie static on his or her back.
Untie fitted outfit and cover the victim with a blanket. Do not provide the victim with fluids.
If vomiting or bleeding from the mouth occurs, turn the victim on his or her side to avoid clogging.
If there are no signs of inhalation and movement, initiate CPR.

4.Septic Shock:

Septic shock is a serious condition which occurs when a generalized (body-wide) infection causes seriously low blood pressure.
This is due to cellular poisoning followed by circulatory failure.
It is the consequence of system-wide bacteriological, viral, or fungal infection, identified as sepsis.
These infections lead to low blood pressure and poor organ function.

Causes of Septic Shock:

Any kinds of bacteriological infection
Sometimes viral or fungal infections

Symptoms of Septic Shock:

Since the septic shock is openly linked to sepsis, the symptoms are similar.
Common symptoms include:
- Low urine production
- Confusion
- Low blood pressure
- Palpitations
- Dizziness, and respiratory complications
- Fever
- Tachycardia, and tachypnea are also usually existent.

5. Neurogenic Shock:

Neurogenic shock occurs due to spinal or brainstem injury with loss of sympathetic vasodilation and decrease in cardiac output.
Neurogenic shock causes blood vessels to dilate which makes the skin warm and flushed.

Causes of Neurogenic Shock:

Damage to the central nervous system, primarily spinal cord injury

Symptoms of Neurogenic Shock:

Sudden low blood pressure
Warm, reddened skin caused by abrupt vasodilation
Reduced heart rate

First aid measures for Neurogenic Shock

Call instant medical care any phase when an individual has signs of shock.
Do not postpone for a warning sign to exacerbate in advance calling for assistance.
While on the way to the emergency room, monitor the individual’s air route, inhalation and blood flow.
Administer CPR and if the individual is breathing on his or her own, carry on to monitor breathing every 2 minutes until service lands.
Do not move an individual who might have supposed the spinal injury
Let the victim lie static on his or her back with the feet elevated above the head to escalate blood circulation to vital organs.
Keep the individual warm and easy. Untie fitted outfit and the cover victim with a blanket.
Do not provide fluids by mouth, although the individual protests of dehydration. There is a choking possibility in the occurrence of an unexpected loss of cognizance.