Medical professionals like, doctors, first aid providers, pharmacists, and nurses often come across the term “shock” or “hypoperfusion”. We are going to explain to you through the video below, and a detailed article about what is shock, its types, signs, symptoms, and possible treatment options. 

The video explains the shock and its different types in just 120 seconds in a very brief and easy-to-understand way.

The video already gained 500K+ views on our YouTube Channel so far and increasing. Don’t believe it? See yourself here at Lifestyle by IK YouTube Channel.

If you are going to provide first aid, you must understand all types of shock. For that reason, we have also written details of the shock below. This is in case you don’t find anything in the video above.

Definition of Shock

“Shock is defined as the inability of the circulatory system of our body to supply cells with oxygen.”

When the body is unable to get blood flow to the organs, tissues, and cells, this becomes life-threatening which leads to organ failure and ultimately death. Because of the severity of the condition, a quick fist aid is required.

In the early stages, symptoms occur as the body attempts to compensate for blood loss.

 

 

Signs and Symptoms

The following are the signs and symptoms of shock:

  • Chest pain
  • Unconsciousness
  • Nausea
  • Low sugar levels
  • Low blood pressure
  • Pale, cool skin
  • Dizziness
  • Rapid pulse
  • Dilated pupils
  • Lightheadedness or fainting
  • Weakness
  • Agitation or anxiety
  • Restlessness
  • Blue colored lips (gray if a person has a dark complexion)
  • Blue colored fingernails (gray in case of a dark complexion)
  • Sweating
  • Moist skin

Causes

Causes of shock may include:

  • Sepsis
  • Massive infection or an anaphylactic or severe allergic reaction may also cause shock from vasodilation.
  • Accident causing heavy internal or external bleeding
  • Severe infection in the body

Physiological causes of shock are the heart failing to pump (heart attack or heart failure). Loss of blood volume or vessels dilating creating a vascular container capacity that is too great to be filled by available blood. This may be due to excessive bleeding or dehydration.

 

 

Types of Shock

There are 5 different types that are as follows:

  • Compensated
  • Decompensated
  • Hypovolemic or hemorrhagic shock
  • Cardiogenic
  • Neurogenic

Now let’s learn about these types one by one.

Compensated Shock

It presents as an increased heart rate, increased respiration, and constriction of peripheral circulation. This results in pale cool skin. In infants and children, increased capillary refill time occurs.

Decompensated Shock

It starts with low blood volume or a lack of perfusion. Symptoms include falling blood pressure. Shock is irreversible when perfusion to the organs cannot be restored.

Cell damage occurs, especially in the liver and kidneys. Even if vital signs are restored, irreparably damaged organs may cause death.

 

 

Hypovolemic or Hemorrhagic Shock

So, what is hemorrhagic shock or hypovolemic shock? It is caused by uncontrolled hemorrhage, internal or external, or both, or by plasma loss in burns or crush injuries.

Treatment

The first hemorrhagic shock treatment is to manage the source of bleeding as quickly as possible and fluid replacement. In controlled hemorrhagic shock (CHS) where the source of bleeding has been occluded fluid substitute is aimed towards normalization of hemodynamic parameters.

In uncontrolled hemorrhagic shock (UCHS) wherein bleeding has briefly stopped due to hypotension, vasoconstriction, and clot formation, the fluid therapy is aimed toward restoration of the radial pulse, or restoration of sensorium or acquiring a BP of 80 mmHg by aliquots of 250 ml of lactated Ringer’s solution (hypotensive resuscitation). When evacuation time is shorter than one hour (often city trauma) instant evacuation to a surgical facility is indicated after airway and breathing. (Source)

 

 

Cardiogenic Shock

Cardiogenic shock occurs during a myocardial infarction or heart attack; damaged heart muscle; or electrical malfunctioning decreases the strength of the heart’s contractions causing a slow-fast or irregular heartbeat.

Symptoms

Cardiogenic shock symptoms include:

  • Lack of consciousness
  • Fast respiration
  • Extreme shortness of breath
  • Sudden, fast heartbeat (tachycardia)
  • Weak pulse
  • Low BP (hypotension)
  • Sweating
  • Pale skin
  • Cold hands or feet
  • Urinating lower than regular or by no means

Causes

Causes of cardiogenic shock include an absence of oxygen to your heart, often from a heart attack, which damages its major pumping chamber (left ventricle). Without oxygenated blood flowing to that area of your heart, the heart muscle can weaken and go into cardiogenic shock.

Not often, injury to your heart’s right ventricle, which sends blood to your lungs to get oxygen, results in cardiogenic shock.

Different possible causes of cardiogenic shock include:

  • Myocarditis
  • Endocarditis
  • Weakened heart from any trigger
  • Drug overdoses or poisoning with substances that may have an effect on your heart’s pumping capability

Manifestations of cardiogenic shock

Manifestations of cardiogenic shock include quick restoration of BP and heart function while taking patients in an ambulance or in an emergency room.

Emergency medical treatment may include enriched oxygen in a tube or masks; respiratory assistance (ventilator); intravenous (IV) fluids and medicines to boost BP or heart function.

There may be an array of medicines that may be given to deal with cardiogenic shock. These differ relying upon the reason for it and will include:

  • Thrombolytic medicine to dissolve coronary artery clots (“clot-busting” drugs similar to tPA)
  • Anti-clotting agents to stop new clots (e.g., aspirin, clopidogrel, heparin)
  • Medication to extend the heart’s pumping capacity (e.g., dobutamine, dopamine, epinephrine)
  • Different potential therapies include oxygen to guard heart tissue; nitroglycerin to widen coronary vessels; medication to lower the heart’s workload and pain, relieve anxiety or regulate heart rhythm

Neurogenic Shock

It may result from the uncontrolled dilation of vessels due to nerve paralysis in spinal cord injuries. There is no blood loss, but the vessel dilation increases the capacity of the circulatory system and available blood can no longer fill it.

You might also like reading: Top 5 Habits that are Bad for Your Heart

 

 

Shock Treatment

Before proceeding with the shock treatment, your first and foremost course of action should be to call 911 or any other local emergency number of your respective country to get immediate medication attention.

You need to stay with the person. You should also stay on the call with the emergency team as they may provide you important instructions to handle the situation at the time.

As a first aid provider, for almost all types of shocks, the first line of treatment is fluid resuscitation. This means you should provide the patient with a large volume of IV fluids. As a result of this, the BP of the patient will increase.

IV fluids may be administered by the ambulance staff when they are on their way to the hospital or may be administered in the emergency room.

Do not administer fluids by mouth. There is a chance of choking in case the patient gets unconscious.  Do not do this even if the patient complains of thirst or dry mouth.

After you have called 911 or your local emergency, you can perform the following first aid:

  • Lay the patient down straight
  • Slightly raise the legs & feet and make sure the patient doesn’t feel pain
  • Keeping the patient still is preferred; don’t move unless it is very necessary.
  • If you see there are no signs of life like breathing, movement or coughing, etc. then start the Cardiopulmonary Resuscitation (CPR), if you have training.
  • The patient may be wearing tight clothes, lose them immediately to prevent the patient from suffocation.
  • It may be due to an external injury, you should apply direct pressure to the wound site to prevent blood loss.
  • If the patient feels chills or very cold, cover with a blanket.
  • The patient may show signs of bleeding from the mouth or vomiting, which may cause choking. To prevent this, turn the patient aside. Make sure this doesn’t cause spinal injury in case the patient is injured from the back.

 

 

In Conclusion

Shock or hypoperfusion is a life-threatening medical condition in which there is reduced oxygen supply to the cells through the circulatory system. This causes a reduced blood supply to the organs, as a result, they stop functioning. There are 5 different types, compensated, decompensated, hypovolemic or hemorrhagic, cardiogenic, and neurogenic. Medical treatment depends on the type of shock a person encounters. As an Emergency Medical Technician (EMT), you do not need to diagnose the type; instead, you must recognize and treat for it whenever there is a mechanism of injury or signs that indicate the possibility of shock. Always call the emergency helpline in your local area of your respective country.

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