Definition and cause
Shock covers a condition where the circuit is failing its duty to provide the body with enough blood. There is a collapse like state.
Shock can be divided into 4 main groups depending on the underlying cause:
- Cardiogenic shock: The heart works unsatisfactory, and pumps therefore inadequate with blood around. Can be viewed by myocardial infarction, pulmonary embolism, heart rhythm disturbances, and / or congestive heart failure (failure).
- Hypovolaemic shock: Blood path loses too much blood or fluid to maintain a reasonable blood pressure. This can be seen by sårskade with great bleeding, by bleeding ulcer, with burns patients who lose very fluid, or by severe diarrhea and dehydration.
- Anaphylactic shock:By exposure to a substance you are allergic to (an allergen), can karbanen expanding very inappropriate. Mon least not blood, but blood pressure drops significantly, when blood volume can not fill the large spaces in the blood vessels up.
- Septic shock:Included in the context of severe infection, where a micro-organism (bacteria, viruses, fungi) infects the bloodstream and give blood poisoning, sepsis. Karbanen reacts with the expansion similarly to anaphylactic shock, and it gives blood pressure dropped.
They speak of shock when the systolic (high) blood pressure (see more below High blood pressure drops below 80-90 mmHg. Depending on the person's normal blood pressure, this may fluctuate.
If there is only a state of shock, this may develop into a vicious circle. Decreased blood flow to vital organs as the heart, brain, kidney and liver will initially make that all blood vessels from less vital organs as skin, muscles and gastrointestinal lock themselves together and "pushing" the blood of the important parts of the body. This gives the classic symptoms (see below). But this is not sufficient to supply the vital organs, the blood vessels in these expanding, the desire
Symptoms of shock
It is very clear that determine whether a person has gone into orbit shock.
The person will be very weak (preshockeret) or collapse (shock), and there will often be seen:
- Pale skin.
- Weak irregular heartbeat.
- Increased breathing.
- Klamt Sweating.
- Blurred consciousness.
Byanaphylactic -andseptic shockis the sick are often red and hot because of the enlarged veins in the skin. There may be choking symptoms associated with anaphylactic shock, for example. by hornets plug in the neck.
Can be seen from any symptoms. Fundamental disease, infection, heart disease and more.
In a blood pressure measurement are low blood pressure. Kidneys, whose function is to regulate water and salt balance can be put entirely out of operation, and there will be no or very sparse urine from the sick.
Precautions and diagnosis
Are you familiar with the allergy, it is obviously important to avoid exposure to the operative cause (for example, peanuts or hornets jack).
Finding a person who has gone into shock, it is very important to quickly summon medical help, and if you are trained to start first. The sick can not help themselves. Any form of operative reason to be as far removed as possible (especially important to halt any. Haemorrhage)
The diagnosis made by the physician at the very clear signs, and the low blood pressure. It takes an electrocardiogram (ECG), measuring cardiac electrical shock, and so it can determine whether the shock is heart-related (cardiogenic shock).
Treatment of shock
It is important that the doctor soon finds out what kind of shock it is. Treatment aligned with the shock-type.
In all cases, it is important to have sufficient oxygen, so oxygenated blood is optimal. We will start intensive fluid therapy up, especially if the shock caused by blood / fluid shortage. There can be treated with saline or blood substitutes depending on the case.
Byanaphylactic shockit is important to get the blood vessels to pull together again as blood pressure could come up again. The injection of adrenaline into a vein will in most cases could increase pressure enough, and the substance acts on the heart by telling it to pump more powerful.
Adrenalin can also be used for other types of shock after having fed enough liquid, and heart can withstand stress.
Byseptic shockit is important that the infection is treated with large doses of antibiotics into a vein.
If the shock caused by heart trouble, directed reading simultaneously against heart disease. Sometimes you need to remove fluid from the body to relieve pressure on the heart.
Select and complications
Shock is a very serious condition, and no emergency care is fatal condition.
Where swift action against ithypovolaemic shockthe prognosis is good if it is possible to find the cause (for example. a bleeding) and stop this.
Itkardiogene shockis more serious in nature, since the shock depends on a mistake of the heart. Depending on heart disease can cause complications as fluid in the lungs (lungestase), which may cause severe breathing problems and anemia to the intestines.
In all cases, it is important to get the kidney again, since these are the reasons no blood supply. This attempt with diuretic agents (diuretics), but in severe cases, you need to use hemodialysis.
The septic shockwith bacteria in the bloodstream has a poor prognosis.
The allergic shockhave a better prognosis, if treated quickly.
Untreated shock leads to death, and relies on shock-type mode is still associated with high mortality.
It is not uncommon to see some degree of permanent damage to organs as kidneys, liver and brain after a shock state.