Shock

  • Definition

    Shock occurs when inadequate blood flow threatens the function of multiple organs. Shock is a potentially life-threatening condition. The sooner it is treated, the better the outcome. If you suspect someone is in shock, call for medical help right away.
  • Causes

    Some causes of shock include:
    • Congestive heart failure
    • Heart attack
    • Spinal cord injury
    • Sepsis—infection of the blood
    • Other severe infection
    • Allergic reaction
    • Poisoning
    • Loss of blood volume (hypovolemia)—this can be from severe bleeding or severe dehydration
    • Heatstroke
    • Trauma
    • Severe hypoglycemia
    • Stroke
  • Risk Factors

    The following factors increase your chances of developing shock:
    • Pre-existing heart or blood vessel disease
    • Impaired immunity
    • Severe allergies
    • Severe trauma
    • Diabetes
  • Symptoms

    The symptoms of shock depend on the cause.
    Symptoms may include:
    • Weakness
    • Altered mental status
    • Cool and clammy skin
    • Pale or mottled skin color
    • Low blood pressure
    • Decreased urination
    • Weak and rapid pulse
    • Slow and shallow or rapid and deep breathing
    • Lackluster (dull) eyes
    • Dilated pupils
    • High or low body temperature
    Symptom of Shock
    Dilated and Constricted pupil
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  • Diagnosis

    A physical exam will be done.
    Tests may include the following:
    • Breathing assessment
    • Blood pressure measurement
    • Heart rate monitoring
    • Other testing depending on the cause of shock
      • Blood tests and cultures
      • Electrocardiogram
      • Imaging studies
  • Treatment

    Treatment options include the following:
    Breathing Resuscitation
    If you are having trouble breathing, your doctor will clear your airway. Oxygen and breathing assistance may be provided if you need it.
    Optimizing Blood Pressure and Heart Rate
    You will receive an IV for fluids and/or blood transfusions. These will stabilize your blood pressure and heart rate.
    Insertion of IV for Transfusion or Medications
    IV insertion
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    Medications
    You may be given vasopressor medications. These constrict your blood vessels to increase blood pressure. Drugs may also be used to increase your heart contractions. Other medications may be used depending on the underlying cause.
  • Prevention

    To help reduce your chances of getting shock, take the following steps:
    • Prevent or control heart or vascular disease.
    • Avoid activities that put you at risk of falls or other injuries.
    • Carry an epinephrine pen with you if you have a severe allergy.
    • Manage conditions, such as diabetes, as advised by your doctor.
  • RESOURCES

    American College of Emergency Physicians http://www.acep.org

    National Heart, Lung, and Blood Institute http://www.nhlbi.nih.gov

    CANADIAN RESOURCES

    Canadian Association of Emergency Physicians http://caep.ca

    Canadian Red Cross http://www.redcross.ca

    References

    Hypovolemic shock. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated December 3, 2013. Accessed January 7, 2014.

    The signs of hypovolemic shock. Health Guidance website. Available at: http://www.healthguidance.org/entry/12784/1/The-Signs-of-Hypovolemic-Shock.html. Accessed January 7, 2014.

    What is cardiogenic shock? National Heart, Lung, and Blood Institute website. Available at: http://www.nhlbi.nih.gov/health/health-topics/topics/shock/printall-index.html. Accessed January 7, 2013.

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