Shock (circulatory)

Shock
US Navy EMT trainees and firemen using IV fluid replacement in treating a trauma training mannequin to prevent hypovolemic shock
SpecialtyCritical care medicine
SymptomsInitial: Weakness, fast heart rate, fast breathing, sweating, anxiety, increased thirst[1]
Later: Confusion, unconsciousness, cardiac arrest[1]
TypesLow volume, cardiogenic, obstructive, distributive[2]
CausesLow volume: Severe bleeding, vomiting, diarrhea, dehydration, or pancreatitis[1]
Cardiogenic: severe heart attack (especially of the left or right ventricles), severe heart failure, cardiac contusion[1]
Obstructive: Cardiac tamponade, tension pneumothorax[1]
Distributive: Sepsis, spinal cord injury, certain overdoses[1]
Diagnostic methodBased on symptoms, physical exam, laboratory tests[2]
TreatmentBased on the underlying cause[2]
MedicationIntravenous fluid, vasopressors[2]
PrognosisRisk of death 20 to 50%[3]
Frequency1.2 million per year (US)[3]

Shock is the state of insufficient blood flow to the tissues of the body as a result of problems with the circulatory system. Initial symptoms of shock may include weakness, fast heart rate, fast breathing, sweating, anxiety, and increased thirst.[1] This may be followed by confusion, unconsciousness, or cardiac arrest, as complications worsen.[1]

Shock is divided into four main types based on the underlying cause: hypovolemic, cardiogenic, obstructive, and distributive shock.[2] Hypovolemic shock, also known as low volume shock, may be from bleeding, diarrhea, or vomiting.[1] Cardiogenic shock may be due to a heart attack or cardiac contusion.[1] Obstructive shock may be due to cardiac tamponade or a tension pneumothorax.[1] Distributive shock may be due to sepsis, anaphylaxis, injury to the upper spinal cord, or certain overdoses.[1][4]

The diagnosis is generally based on a combination of symptoms, physical examination, and laboratory tests.[2] A decreased pulse pressure (systolic blood pressure minus diastolic blood pressure) or a fast heart rate raises concerns.[1]

Shock is a medical emergency and requires urgent medical care. If shock is suspected, call for emergency help immediately. While waiting for medical care, if safe to do so, lay the person down (unless a head or back injury is suspected), elevate their legs if possible, and keep them warm. If the person is unresponsive, monitor their breathing and be ready to perform CPR if necessary.[5]

  1. ^ a b c d e f g h i j k l m International Trauma Life Support for Emergency Care Providers (8 ed.). Pearson Education Limited. 2018. pp. 172–73. ISBN 978-1292-17084-8.
  2. ^ a b c d e f ATLS – Advanced Trauma Life Support – Student Course Manual (10 ed.). American College of Surgeons. 2018. pp. 43–52, 135. ISBN 978-78-0-9968267.
  3. ^ a b Cite error: The named reference Tab2010 was invoked but never defined (see the help page).
  4. ^ Smith, N; Lopez, RA; Silberman, M (January 2019). "Distributive Shock". StatPearls (Internet). PMID 29261964.
  5. ^ "Shock". Red Cross. Retrieved 2024-10-21.

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