Shock - Causes and Signs of Shock

Types of shock

Experts distinguish the following types of this condition:

• cardiogenic;
• hypovolemic;
• redistributive or distributive.

According to another classification, shock is:

• hypovolemic;
• cardiogenic;
• traumatic;
• septic;
• neurogenic;
• anaphylactic;
• combined.

The following types of this condition are also distinguished:

• vascular shock - combines neurogenic, septic, anaphylactic types of shock. Develops with vasoconstriction caused by bacterial infection, spinal cord or brain injury;
• hypovolemic - includes anhydremic and hemorrhagic shock;
• pain shock - combines burn and traumatic shock;
• cardiogenic shock;

This condition is characterized by the following stages:

• Grade I or compensated - characterized by the preservation of consciousness, the patient makes contact, but he is slightly inhibited. Has a favorable prognosis;
• Grade II or subcompensated - characterized by the patient's inhibition, pale skin, muffled heart sounds, shallow and rapid breathing. Anti-shock measures are required;
• Stage III or decompensated – adynamia and lethargy develop. There is no response to pain. The patient speaks quietly and weakly, confusion is typical;
• Stage IV or irreversible – a terminal condition develops. The patient is unconscious, the skin becomes marbled with the presence of stagnant spots like cadaveric ones. The pulse is barely palpable. The prognosis is extremely unfavorable.

Specialists distinguish the following stages of shock:

• Stage 1, compensated or non-progressive – perfusion of vital organs is typically maintained, which occurs due to compensatory mechanisms;
• Stage 2 or progressive – a condition develops when compensatory mechanisms are no longer able to maintain the necessary perfusion. The progression of all pathogenetic mechanisms that lead to the development of shock is launched;
• the stage of irreversible changes or stage 3 - it is impossible to improve the patient's condition with the help of medical intervention.

Causes

Causes of shock development:

• infection with a bacterial infection (peritonitis, sepsis, gangrenous process);
• spinal cord injury;
• medulla oblongata injury;
• ingress of an allergen into the human body;
• taking plasma preparations, as well as plasma proteins;
• anesthetics and radiocontrast agents;
• taking medications;
• deficiency circulating blood;
• decreased secondary cardiac output;
• decreased venous return;
• dehydration;
• loss of plasma and blood;
• heart failure;
• inability of blood vessels to hold;
• lack of oxygen;
• trauma;
• burn;
• external and internal bleeding;
• homeostasis disorders.
• hypoxia;
• myocardial infarction;
• cardiac contusion;
• "bending" of the heart during tension pneumothorax;
• taking large doses diuretics;
• blood transfusion of a different blood group;
• liver necrosis.

A state of shock can be caused by several reasons at the same time.

The most common reason that leads to the development of a state of shock is severe blood loss. For an adult to develop this condition, it is necessary to lose about 2 liters of blood.

Symptoms

Symptoms of shock:

• decreased blood pressure (may be completely absent);
• increased heart rate or, conversely, the pulse may become “soft”, weak and “threadlike”;
• increased breathing;
• severe weakness;
• paleness of the skin;
• the skin may become pale bluish or pale yellow;
• lack of urine;
• lack of response to pain;
• loss of consciousness.

Not always this condition ends in death. Shock can develop within a couple of minutes, hours. The sooner this condition is diagnosed, the greater the chance of saving a person's life.

Diagnostics

When the first signs appear that may indicate the development of shock, you must immediately make an appointment with a resuscitator. During the examination, a consultation with an anesthesiologist is possible.

To confirm the diagnosis, the doctor will prescribe the following tests:

• questioning;
• external examination of the patient;
• measurement of blood pressure (using the Korotkov method);

Treatment

To effectively treat shock, it is necessary to establish the cause that caused it. To treat a state of shock, the following measures are taken:

• stop bleeding (if any);
• artificial respiration;
• put an anti-shock suit on the patient;
• drug therapy;
• surgical treatment by a surgeon;
• artificial ventilation of the lungs.

Prevention

Prevention of this condition consists of timely treatment of diseases that can lead to its development.