We have changed our visitation policy for the safety of our patients and staff. Click here for the updated visitation policy and click here for information about COVID-19.

by McCoy K

Definition

Shock is the inadequate blood flow threatens the function of multiple organs. Shock is a potentially life-threatening condition. The sooner it is treated, the better the outcome. If you suspect someone is in shock, call for medical help right away.

Causes

Some causes of shock include:

  • Heart failure
  • Heart attack
  • Spinal cord injury
  • Systemic infection— sepsis
  • Other severe infection
  • Allergic reaction
  • Poisoning
  • Loss of blood volume (hypovolemia)—this can be from severe bleeding or severe dehydration
  • Heatstroke
  • Trauma
  • Severe hypoglycemia
  • Stroke

Risk Factors

Factors that may increase your chances of shock:

  • Pre-existing heart or blood vessel disease
  • Impaired immunity
  • Severe allergies
  • Severe trauma
  • Diabetes

Symptoms

The symptoms of shock depend on the cause. Shock can lead to:

  • Weakness
  • Problems with thought process, alertness, awareness, or changes in behavior
  • Decreased urination

Shock can also cause:

  • Cool and clammy skin
  • Pale or mottled skin color
  • Slow heartbeat
  • Slow and shallow or rapid and deep breathing
  • Dull eyes
  • Pupils of the eye are larger than normal
Symptom of Shock
Dilated and Constricted pupil
Copyright © Nucleus Medical Media, Inc.

Diagnosis

A physical exam will be done. Tests may include:

  • Breathing assessment
  • Blood pressure measurement
  • Heart rate monitoring

Other tests may be done to look for a cause. Tests may be:

  • Blood tests and cultures
  • ECG
  • Imaging tests

Treatment

Shock will need emergency care. Treatment will help to improve blood flow and stop further damage. Care may include:

  • Fluids or blood will be given through an IV. It will help to get blood pressure and heart rate to safer levels.
  • The airway may need to be supported if there are breathing problems. Oxygen or other treatment will also make breathing easier.
  • Medicine can help to increase blood pressure and blood flow. Vasopressors can open blood vessels to improve blood flow. Other medicine can make the heart beat more forcefully.
Insertion of IV for Transfusion or Medications
IV insertion
Copyright © Nucleus Medical Media, Inc.

Other treatment may be needed to treat the cause of shock.

Prevention

To help reduce your chances of shock:

  • Prevent or control heart or vascular disease.
  • Avoid activity that puts you at risk of falls or other injuries.
  • Carry an epinephrine pen with you if you have a severe allergy.
  • Follow care plan for health issues, such as diabetes.

RESOURCES

American College of Emergency Physicians  https://www.acep.org 

National Heart, Lung, and Blood Institute  https://www.nhlbi.nih.gov 

CANADIAN RESOURCES

Canadian Association of Emergency Physicians  http://caep.ca 

Canadian Red Cross  http://www.redcross.ca 

References

Cardiogenic shock. EBSCO DynaMed Plus website. Available at:  https://www.dynamed.com/topics/dmp~AN~T115657/Cardiogenic-shock  . Accessed September 17, 2020.

Cardiogenic shock. National Heart, Lung, and Blood Institute website. Available at: https://www.nhlbi.nih.gov/health-topics/cardiogenic-shock. Accessed September 17, 2020.

The signs of hypovolemic shock. Health Guidance website. Available at: http://www.healthguidance.org/entry/12784/1/The-Signs-of-Hypovolemic-Shock.html. Accessed September 17, 2020.

Revision Information