The state of shock It is a condition in which there is not enough oxygen in the blood due to very low blood pressure. This causes the organs and tissues to lack the oxygen they need, causing cells to die and waste to accumulate..
There are very different conditions that can cause the drop in blood pressure that, as a consequence, produces a state of shock. Some of them are decreased blood volume, malfunction of the sympathetic nervous system, hormonal alterations, allergies, etc. According to its causes, shock can be classified into different subtypes.
The word shock is used differently in the medical field and in the general public. It is popularly used to define an intense emotional reaction that arises in stressful situations, such as receiving bad news.
In this case, shock refers to a loss of oxygen in the blood that results in symptoms such as increased heart rate, confusion, or fatigue..
Shock is a medical emergency that can cause serious injury, and even death. That is why it must be treated immediately.
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It is important to mention that it is essential for cells to have oxygen and glucose. This allows them to generate power and do their job properly..
Oxygen enters the body through the lungs. From these oxygen reaches the blood. Specifically, it is stored in red blood cells, binding to hemoglobin molecules. Red blood cells travel throughout the body thanks to the pumping of the heart, carrying oxygen to cells and tissues.
However, if the cells do not have oxygen, instead of using aerobic metabolism (with oxygen) they use anaerobic metabolism (without oxygen). This metabolism creates lactic acid as a by-product.
This causes the acid-base balance in the blood to change. That is, it becomes more acidic, beginning to release toxins that will affect the blood vessels.
Finally, anaerobic metabolism causes cells to die, which harms different tissues and organs..
There are three known stages of shock, each of which has different symptoms..
In stage I (non-progressive), the body detects low blood flow and sets in motion certain mechanisms to counteract it.
Thus, the heart beats faster, the blood vessels reduce their diameter and the kidney tries to retain fluids. At this stage, shock does not have as many symptoms and quick treatment can stop it..
In stage II (progressive), the above mechanisms fail and identifiable symptoms begin to manifest. For example, the patient begins to feel confused by the lack of oxygen.
In stage III (irreversible) the low pressure affects the tissues and organs, the heart begins to be damaged and the kidneys collapse. At this stage, serious damage occurs that could lead to death..
The most common symptoms of shock are:
- Low blood pressure.
- Cold and clammy skin Hands and feet may be pale or bluish in color.
- The affected person can breathe quickly and with difficulty.
- Accelerated heart rate.
- Sickness.
- Vomiting.
- Urine reduction.
- Fatigue.
- Dilated pupils.
- Dry mouth.
- Dizziness.
- Anxiety.
- Irritability.
- Confusion and drowsiness.
- Altered mental state, with reduced alertness. May advance to loss of consciousness.
There are different types of shock depending on the cause that produces it:
It is characterized by a low volume of blood in the body. For a good functioning of the organism it is necessary that there are enough red blood cells. Also, there needs to be enough water in the blood for fluids to move through the blood vessels. In fact, 90% of blood is water.
When there is dehydration, there may be enough red blood cells, although there is not enough blood volume. This causes the blood pressure to drop. Therefore, if there is less blood to pump, the heart must accelerate its rate to maintain production..
In the advanced stages of this type of shock, the patient cannot replace the amount of fluid lost and the body cannot stabilize blood pressure..
It can also be due to internal bleeding (from a ruptured artery or damage to an organ) or external (for example, from a deep wound). This can also be called hemorrhagic shock..
Its most common causes are gastrointestinal bleeding and bleeding in the uterus in women. On the other hand, this state of shock is common in people with cancer..
This is because they are at higher risk of bleeding, as their liver does not allow proper clotting. People who take blood-thinning medications can also bleed excessively.
Other causes of hypovolemic shock can be dehydration, burns, heat stroke, vomiting or chronic diarrhea that can cause a loss of blood volume, as well as a drop in blood pressure..
It is also associated with diseases that cause excess urination (urine). Some of them are diabetes insipidus and diabetes mellitus. This is because excessively high blood sugar causes excess water to be secreted in the urine..
Inflammation of the pancreas, kidney failure, or severe bleeding in the body can also lead to hypovolemic shock..
This occurs because the heart cannot adequately pump blood from the body. Its origin is linked to heart disease or heart attacks.
This type of shock consists of a dysfunction of the sympathetic nervous system that reduces blood circulation throughout the body. Causes blood vessels to widen, causing blood to pool and blood pressure to drop.
This is generally produced by any type of bacteria, fungi, or virus (although to a lesser extent). When these infections are not treated properly, they lead to the appearance of certain toxins in the bloodstream..
As a consequence, the heart muscle can malfunction. As well as a widening of the diameter of the blood vessels, accompanied by severe arterial hypotension.
The toxins can damage the lungs, or cause acute respiratory failure. They can also cause kidney failure and liver failure..
It is a serious allergic reaction that generates a dilation of the blood vessels, leading to a drop in blood pressure.
This state of shock is caused by an obstruction of blood flow that may be due to cardiac tamponade. For example, compression of the heart by the accumulation of fluid in the pericardium (a tissue that surrounds the heart). Or, by embolism (blood clot in the arteries).
A serious hormonal disorder can cause the heart to malfunction, leading to a drop in blood pressure..
It should be noted that shock is a medical emergency that needs immediate treatment. In the presence of symptoms, you should contact emergency services as soon as possible.
First aid is essential to save the life of the patient. If the person is conscious, the indicated thing is to lay them down and keep them comfortable and warm..
It is advisable to take his legs and raise them above the level of the torso and head. It is important not to move the person if spinal cord injuries or leg fractures are suspected..
If the patient is bleeding, you can try to temporarily control it by pressing a clean cloth to the wound. If the cloth gets soaked it must be replaced or replaced. It is important to keep the pressure in place constantly.
Even if the person is thirsty, it is recommended not to give them drinks or food. It is best to keep the patient calm and not moving.
Treatment of shock varies depending on the underlying causes, that is, the type of shock the person has experienced..
Thus, in hypovolemic shock, the blood volume may have to be increased by means of blood transfusions..
While, in cardiogenic shock, the indicated treatment is the application of medications that narrow the blood vessels so that the heart can pump blood more easily. Blood volume can also be boosted by intravenous fluids.
The treatment of neurogenic shock consists mainly in the administration of fluids into the veins and medications such as corticosteroids..
When it comes to septic shock, antibiotic treatment may be necessary to stop the infection..
On the other hand, anaphylactic shock requires the administration of medications such as antihistamines, corticosteroids or adrenaline..
When obstructive shock occurs, the obstruction needs to be removed. For this, anticoagulant medications can be applied to dissolve clots in the arteries..
Finally, in endocrine shock, drugs must be used to achieve hormonal balance. For example, if it is due to hypothyroidism, drugs should be prescribed to treat it..
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