Shock
General information
Shock is the body's response to the action of external aggressive stimuli, which can be accompanied by impaired blood circulation, metabolism, nervous system, respiration, and other vital functions of the body.
There are such reasons for shock:
1. Injuries resulting from mechanical or chemical effects: burns, lacerations, tissue damage, limb tears, exposure to current (traumatic shock);
2. Concomitant trauma loss of blood in large quantities (hemorrhagic shock);
3. Transfusion of incompatible blood to the patient in a large volume;
4. Ingress of allergens into a sensitized environment (anaphylactic shock);
5. Extensive necrosis of the liver, intestines, kidneys, heart; ischemia.
To diagnose shock in a person who has suffered a shock or injury, you can based on the following signs:
- anxiety;
- blurred consciousness with tachycardia;
- low blood pressure;
- trouble breathing
- decreased volume of urine excreted;
- the skin is cold and moist, marbled or pale cyanotic
The clinical picture of shock
The clinical picture of shock differs depending on the severity of external stimuli. To correctly assess the condition of a person who has undergone shock and provide assistance with shock, several stages of this condition should be distinguished:
1. Shock 1 degree. The person retains consciousness, he makes contact, although the reactions are slightly inhibited. Pulse indicators - 90-100 beats, systolic pressure - 90mm;
2. Shock grade 2. The person's reactions are also inhibited, but he is conscious, correctly answers the questions asked, speaks in a muffled voice. There is rapid shallow breathing, rapid pulse (140 beats per minute), blood pressure is reduced to 90-80 mm Hg. The prognosis for such a shock is serious, the condition requires urgent anti-shock procedures;
3. Shock grade 3. A person has inhibited reactions, he does not feel pain and is adynamic. The patient speaks slowly and in a whisper, he may not answer questions at all, or in monosyllables. Consciousness may be completely absent. The skin is pale, with pronounced acrocyanosis, covered with sweat. The victim's pulse is barely noticeable, palpable only on the femoral and carotid arteries (usually 130-180 beats / min). Shallow and rapid breathing is also observed. Venous central pressure can be below zero or zero, and systolic pressure below 70 mmHg.
4. Shock 4 degrees - this is a terminal state of the organism, often expressed in irreversible pathological changes - tissue hypoxia, acidosis, intoxication. The patient's condition with this form of shock is extremely difficult and the prognosis is almost always negative. The victim's heart is not bugged, he is unconscious and breathes superficially with sobs and convulsions. There is no reaction to pain, the pupils are dilated. In this case, blood pressure is 50 mm Hg, and may not be determined at all. The pulse is also subtle and is felt only on the main arteries. Human skin is gray, with a characteristic marble pattern and spots, similar to cadaveric ones, indicating a general decrease in blood circulation.
Types of shock
The state of shock is classified according to the cause of the shock. So, you can highlight:
- Vascular shock (septic, neurogenic, anaphylactic shock);
- Hypovolemic (anhydremic and hemorrhagic shock);
- Cardiogenic shock;
- Painful shock (burn, traumatic shock).
Vascular shock is shock caused by a decrease in vascular tone. Its subspecies: septic, neurogenic, anaphylactic shock - these are conditions with different pathogenesis. Septic shock occurs as a result of a person becoming infected with a bacterial infection (sepsis, peritonitis, gangrenous process). Neurogenic shock most often occurs after trauma to the spinal cord or medulla oblongata. Anaphylactic shock is a severe allergic reaction that occurs within the first 2-25 minutes. after the allergen enters the body. Substances that can cause anaphylactic shock are plasma and plasma protein preparations, X-ray contrast and anesthetics, and other drugs.
Hypovolemic shock is caused by an acute deficiency of circulating blood, a secondary decrease in cardiac output, and a decrease in venous return to the heart. This shock condition occurs with dehydration, loss of plasma (anhydremic shock) and blood loss - hemorrhagic shock.
Cardiogenic shock is an extremely serious condition of the heart and blood vessels, characterized by a high mortality rate (from 50 to 90%), and resulting from a serious circulatory disorder. In cardiogenic shock, the brain, due to the lack of blood supply (impaired heart function, dilated vessels, unable to retain blood), experiences a sharp lack of oxygen. Therefore, a person in a state of cardiogenic shock loses consciousness and most often dies.
Painful shock, as well as cardiogenic, anaphylactic shock is a common shock condition that occurs during an acute reaction to an injury (traumatic shock) or a burn. Moreover, it is important to understand that burn and traumatic shock are types of hypovolemic shock, because they are caused by the loss of a large amount of plasma or blood (hemorrhagic shock). This can be internal and external bleeding, as well as the exudation of plasma fluid through the burned areas of the skin with burns.
Shock help
When providing assistance with shock, it is important to understand that often the cause of late shock states is improper transportation of the victim and the provision of first aid for shock, therefore, basic rescue procedures before the arrival of the ambulance team is very important.
Help with shock consists of the following activities:
1. Eliminate the cause of the shock, for example, stop bleeding, release pinched limbs, extinguish burning clothing on the victim;
2. Check the presence of foreign objects in the mouth and nose of the victim, if necessary, remove them;
3. Check the presence of respiration, pulse, and, if necessary, carry out heart massage, artificial respiration;
4. Make sure that the victim lies with his head on his side, so he does not choke on his own vomit, his tongue does not sink;
5. Determine if the victim is conscious and give him anesthetic. It is advisable to give the patient hot tea, but to exclude before this injury to the abdomen;
6. Loosen the clothes on the belt, chest, neck of the victim;
7. The patient must be warmed or cooled, depending on the season;
8. The victim must not be left alone, he must not smoke. Also, you can not apply a heating pad to the injured area - this can provoke the outflow of blood from the vital organs.
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The information is generalized and provided for informational purposes only. At the first sign of illness, see your doctor. Self-medication is hazardous to health!
