Shock: Definitions, Types, and Management Principles
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Definitions
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Signs and symptoms of shock
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Classification
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General principles of management
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Specific types of shock
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Shock:
is a disturbance of circulation leading
to inadequate perfusion of vital tissues and
with a wide variation of systemic effects.
Normal tissue perfusion:
requires three intact
mechanisms:
1- A functioning pump (heart)
2- Adequate volume (blood and plasma)
3- An intact vascular system
DHSR Approved Curriculum-Unit 1
1- confusion and delirium.
2- scared appearance.
3- rapid and shallow respiration.
4- rapid and weak pulse.
5- cold and pale skin.
6- nausea and vomiting.
7- reduced blood pressure.
Caused by blood or plasma loss due to:
A- Burns.
B- Bleeding peptic ulcer.
C- Ruptured varices.
D- Extensive fractures.
E- Crushing accidents.
F- External or internal injuries.
Inability of heart to pump needed blood:
Causes:
1- myocardial infarction.
2- cardiac arrhythmia.
3- pulmonary embolism.
4- myocardial contusion.
Caused by failure of nervous system to
control diameter of blood vessels.
Causes:
1- severe pain.
2- spinal injury.
Allergic shock.
Functioning blood vessels is disturbed by
sensitivity to injection of a foreign
substance.
Causes:
1- insect stings.
2- certain medicines (antibiotics)
Occurs in severe infections.
Exotoxins of gram +ve bacteria
(staph aureus)
Endotoxins of gram –ve bacteria
(E coli)
Exotoxin (cell-protein-heat liable)
Endotoxin (cell wall – lipid – heat stable)
1- Carry standard CPR first aid to maintain an
open airway, monitor breathing, and
prevent further blood loss.
2- oxygen to assist respiration.
3-
position:
depending on problem
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Lower extremity elevation (improve
circulation).
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Supine position in fracture of extremities
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Position an unconscious casualty
Semi
prone Position
on his side with his head
turned so fluids can drain from his mouth.
Maintains
airways open and provide best
drainage of vomiting.
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4- control bleeding.
5- keep normal temperature: cover
patient with blanket, remove wet
clothings.
6- start I.V line.
7- drug therapy according to physician’s
order.
8- monitor all vital signs.
9- avoid movement (head , spine, neck
injury)
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Hypovolemic shock:
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Replace volume therapy by I.V fluids
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In massive hemorrhage, more than one
I.V line is required.
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Continuous oxygen to combat hypoxia.
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Correct hypovolemia.
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Appropriate therapy.
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Measure urine volume (catheter).
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Monitor arterial blood gases.
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I.V antibiotic therapy.
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Continue appropriate therapy after culture
and sensitivity results.
Anaphylactic shock
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Ensure open airways.
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Oxygen administration.
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Monitor blood pressure.
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Start I.V line.
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Hydrocortisone administration.
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Antihistaminic.
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Shock is a condition characterized by inadequate tissue perfusion, leading to a range of systemic effects. This article outlines the definitions, signs and symptoms, general principles of management, and specific types of shock, including hypovolemic, cardiogenic, neurogenic, anaphylactic, and septic shock.
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Presentation Transcript
Outlines Definitions Signs and symptoms of shock Classification General principles of management Specific types of shock
Definitions Shock: is a disturbance of circulation leading to inadequate perfusion of vital tissues and with a wide variation of systemic effects. Normal tissue perfusion: requires three intact mechanisms: 1- A functioning pump (heart) 2- Adequate volume (blood and plasma) 3- An intact vascular system
Signs and symptoms 1- confusion and delirium. 2- scared appearance. 3- rapid and shallow respiration. 4- rapid and weak pulse. 5- cold and pale skin. 6- nausea and vomiting. 7- reduced blood pressure.
Classification of Shock by cause
Hypovolemic shock Caused by blood or plasma loss due to: A- Burns. B- Bleeding peptic ulcer. C- Ruptured varices. D- Extensive fractures. E- Crushing accidents. F- External or internal injuries.
Cardiogenic shock Inability of heart to pump needed blood: Causes: 1- myocardial infarction. 2- cardiac arrhythmia. 3- pulmonary embolism. 4- myocardial contusion. Myocardial Infarction
Neurogenic shock Caused by failure of nervous system to control diameter of blood vessels. Causes: 1- severe pain. 2- spinal injury.
Anaphylactic shock Allergic shock. Functioning blood vessels is disturbed by sensitivity to injection of a foreign substance. Causes: 1- insect stings. 2- certain medicines (antibiotics)
Septic shock Occurs in severe infections. Exotoxins of gram +ve bacteria (staph aureus) Endotoxins of gram ve bacteria (E coli) Exotoxin (cell-protein-heat liable) Endotoxin (cell wall lipid heat stable)
General principles of management
1- Carry standard CPR first aid to maintain an open airway, monitor breathing, and prevent further blood loss. 2- oxygen to assist respiration. 3- position: depending on problem Lower extremity elevation (improve circulation). Supine position in fracture of extremities
Position an unconscious casualty Semi prone Position on his side with his head turned so fluids can drain from his mouth. Maintains airways open and provide best drainage of vomiting.
Cont. 4- control bleeding. 5- keep normal temperature: cover patient with blanket, remove wet clothings. 6- start I.V line. 7- drug therapy according to physician s order. 8- monitor all vital signs. 9- avoid movement (head , spine, neck injury)
Specific types of shock Hypovolemic shock: Replace volume therapy by I.V fluids In massive hemorrhage, more than one I.V line is required.
Cardiogenic shock Continuous oxygen to combat hypoxia. Correct hypovolemia. Appropriate therapy. Measure urine volume (catheter). Monitor arterial blood gases.
Septic shock I.V antibiotic therapy. Continue appropriate therapy after culture and sensitivity results. Anaphylactic shock Ensure open airways. Oxygen administration. Monitor blood pressure. Start I.V line. Hydrocortisone administration. Antihistaminic.
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