SHOCK

General Information

DEFINITION--Low blood pressure that is too low for the body to maintain vital functions. Shock does not include a person's reaction to emotional trauma, which is a totally different disorder.

BODY PARTS INVOLVED--Heart; blood vessels; blood.

SEX OR AGE MOST AFFECTED--Both sexes; all ages.

SIGNS & SYMPTOMS

• Cold hands and feet.
• Fast, weak pulse.
• Disorientation or confusion.
• Anxiety with feelings of impending doom.
• Skin that is pale, moist and sweaty.
• Shortness of breath and rapid breathing.
• Lack of urination.
• Low blood pressure. This may be so low that it cannot be measured by usual means.

CAUSES

• Sudden loss of blood from injury or disorders, such as bleeding peptic ulcer, ruptured aneurysm or ruptured ectopic pregnancy (hypovolemic shock).
• Fluid loss, such as occurs with severe burns, fluid and electrolyte imbalance, or peritonitis.
• Impaired heart-pumping function from heart attack, heart-rhythm irregularities, pericarditis or pulmonary embolism (cardiogenic shock).
• Blood poisoning, which causes blood vessels to greatly expand, such as occurs with toxic shock syndrome or major infections (septic shock).
• Some endocrine diseases, such as Addison's disease or diabetes mellitus.

RISK INCREASES WITH

• Recent serious injury; recent surgery.
• Childbirth.
• Anemia; infection; cancer.
• Use of drugs that cause anaphylactic (allergic) shock as an adverse reaction, such as penicillin, local anesthetics and many others.
• Overdose of mind-altering drugs.
• Excess alcohol consumption.

HOW TO PREVENT--Avoid causes and risk factors when possible.

What To Expect

DIAGNOSTIC MEASURES--

• Medical history and physical exam by a doctor.
• Laboratory blood studies to measure the amount of blood in circulation and to measure fluids and electrolytes.

APPROPRIATE HEALTH CARE

• Doctor's treatment.
• Surgery to stop hemorrhaging.
• Hospitalization for intravenous fluids and medications to raise blood pressure and treat the underlying cause.

POSSIBLE COMPLICATIONS

• Cardiac arrest.
• Respiratory arrest.
• Permanent brain damage.

PROBABLE OUTCOME--Usually curable with early diagnosis and treatment. Without treatment, shock can be fatal.

How To Treat

GENERAL MEASURES----If you observe signs of shock in someone, do the following until medical help arrives:

• Stop external bleeding by applying pressure.
• Keep the victim lying down with legs elevated. Cover the victim for warmth.
• Make sure the victim's airway is open to allow breathing. If breathing stops, give mouth-to-mouth resuscitation. If breathing and pulse stop, give cardiopulmonary resuscitation.

MEDICATION--Depends on the underlying disorder:

• If shock is from blood or fluid loss, treatment includes blood transfusion or intravenous fluids.
• If blood pressure is at a life-threatening low level, hypertensive drugs to raise blood pressure may be given.
• If infection is present, antibiotics will be used.

ACTIVITY--Rest in bed until completely recovered. Move legs actively while in bed to decrease the likelihood of deep-vein blood clots.

DIET--No special diet.

Call Your Doctor If

• You have symptoms of shock or observe them in someone else. Call immediately. This is a life-threatening emergency!
• New, unexplained symptoms develop. Drugs used in treatment may produce side effects.