Shock: Signs, Symptoms,Causes and Treatment.

Shock: Signs, Symptoms,Causes and Treatment.

Shock is defined as a state of cellular and tissue hypoxia due to reduced oxygen delivery and/or increased oxygen.consumption or inadequate oxygen utilization. Shock is initially reversible, but must be recognized and treated immediately to prevent progression to irreversible organ dysfunction.

Types of Shock.

The main types of shock include:

Cardiogenic shock (due to heart problems) ;It occurs when effective circulating volume decreases despite normal or increased blood volume and appropriate systemic resistance.

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Hypovolemic shock (caused by too little blood volume) :Hypovolemic shock occurs when blood volume is decreased through hemorrhage, third space fluid distribution, or dehydration.

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  • .Anaphylactic shock (caused by allergic reaction)

Septic shock (due to infections)

Neurogenic shock (caused by damage to the nervous system)

Types of shock

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1.Cardiogenic shock (due to heart problems) ;

It occurs when effective circulating volume decreases despite normal or increased blood volume and appropriate systemic resistance.

Etiology:

• damage to heart muscle

• irregular heart rhythm

• very slow heart rhythm

• CHF

Clinical signs

  • cardiac murmurs,
  • arrhythmias,
  • bloody froth coming from the mouth or nasal cavity
  • Orthopnea(shortness of breath )
  • cyanosis.

2.Hypovolemic shock

Hypovolemic shock occurs when blood volume is decreased through hemorrhage, third space fluid distribution, or dehydration.

Etiology:

  • Trauma
  • Wound
  • Internal Bleeding

3. Anaphylactic Shock

It is a complication of a severe allergic reaction known as Anaphylaxis. Allergic reactions occur when the body of animal mistakenly treats a harmless substance as harmful. This triggers a dangerous immune response.

Etiology:

Anaphylaxis is usually caused by allergic reactions to food, insect venom, medications, or latex

4. Septic Shock

• Septic shock occurs when toxins of bacteria cause serious damage to tissues or organs in the body.

• It is a condition caused by infections that lead to bacteria entering bloodstream.

• It is also known as blood poisoning.

Etiology:

Invasion of bacteria and their toxins

5. Neurogenic Shock

• It is caused by damage to the central nervous system, usually a spinal cord injury.

• This causes blood vessels to dilate, and the skin may feel warm and flushed.

• The heart rate slows, and blood pressure drops very low.

Symptoms

In General the symptoms of all types of shock include:

• Rapid, shallow breathing, Cold, Clammy skin,

• weak pulse, Dizziness or fainting, Weakness

Depending on the type and severity of shock the following symptoms may also be observed.

  • Tachycardia and tachypnoea.
  • Weak and thready pulse. §Hypotension
  • Skin cool and clammy.
  • Eyes appear to stare, Anxiety or agitation §Seizures, Confusion or unresponsiveness
  • Low or no urine output, Bluish lips and fingernails

Diagnosis

History, Sign and Symptoms

  • From Blood pressure measurement.
Lab tests such as:
  • Electrocardiogram (ECG),
  • Chest X-ray,
  • Blood tests
  • Cardiac catheterization (angiogram) for cardiogenic shock.

Treatment

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1. Cardiogenic shock

  • Cardiogenic shock is treated dependent on the underlying heart disease -fluid therapy is generally contraindicated in these patients.
  • Airway management by mechanical ventilation.
  • Vasoactive agent such as Dobutamine, Dopamine etc can be used to produce cardiac stimulation and vasoconstriction.

2. Hypovolemic Shock:

  • Fluid perfusion to increase BP,
  • – Normal Saline (154 meq Sodium, 154 meq Chloride)
  • – Ringer’s Lactate (135 meq Sodium, 109 meq Chloride)
  • Most animals with moderate to severe shock will receive a bolus of 20–40 ml/kg over 15–30 minutes which may be repeated

3. Anaphylactic shock

  • Fluid infusion by IV route.
  • Use of Anti-histamine such as Diphenyhyramine 50 mg IV, Chlorpheniramine.
  • Immediate withdrawal of antigen as possible.
  • Different corticosteroids can be used for treatment.

4. Neurogenic shock

  • Treat and remove the underlying cause.
  • Prevent cardiovascular instability and promote tissue perfusion.
  • Use Atropine in case of bradycardia.
  • Regulate temperature fluctuation to optimize at normal.

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