SHOCK

CHRISTOPHER RYALINO
 BASIC OVERVIEW
Shock is an acute circulatory
failure leading to inadequate
tissue perfusion resulting in
generalized cellular hypoxia.
Shock is a life-threatening situation,
which in any circumstances, must be
treated properly and effectively.
 BASIC OVERVIEW

The golden rule of “time saving is

life saving” is also a golden rule of
shock.
Understanding the mechanism
leading to shock is very helpful to
determine our course of action.
 TYPES OF SHOCK

HYPOVOLEMIC SHOCK, due to loss of plasma,

blood, body fluid, and electrolytes.
CARDIOGENIC SHOCK, due to cardiac failure or
abnormalities.
DISTRIBUTIVE SHOCK, due to vascular failure
to perfuse the fluids.
 HYPOVOLEMIC: Common Cause

Bleeding
Loss of plasma (burns)
Loss of fluids from vomiting, diarrhea, or
excessive sweating
Hyperosmolar states as in diabetic
ketoacidosis
Internal “third spacing” of fluid as seen in
diseases like pancreatitis.
 CARDIOGENIC: Common Causes

Pump failure due to myocardial infarction or other

cardiomyopathy
Vascular dysfunction
 DISTRIBUTIVE: Common Causes

OBSTRUCTIVE CAUSES:
 Tension Pneumothorax
 Pulmonary embolism
 Obstructive valvular diseases
DISTRIBUTION CAUSES:
 Septic shock (infection)
 Anaphylactic shock (hypersensitivity reaction)
 Neurogenic shock (spinal trauma)
 Vasodilator drugs
 CLASSIC MANIFESTATION: SHOCK

DECREASED BLOOD PRESSURE

INCREASED PULSE RATE
INCREASED RESPIRATION RATE
DECREASED URINE PRODUCTION
DECREASED ALERTNESS
SWEATING, CYANOSIS
ECG ABNORMALITIES
 GENERAL GUIDELINES: SHOCK

RESUSCITATION
 SECURE AIRWAY AND BREATHING
 OXYGEN MASK
 STOP BLEEDING OR FLUID LOSS (IF ANY)
FLUID REPLACEMENT THERAPY
 FLUID THERAPY IS GIVEN INTRAVENOUSLY
 DEPENDS ON WHAT FLUID IS LOSING
 ALSO INCLUDES: BLOOD TRANSFUSION
MONITORING
 MONITOR ALL VITAL SIGNS
 BLOOD ANALYSIS (CBC, BGA, ELECTROLYTES, ETC.)
 RESUSCITATION IS YOURS

Do not leave casualty unattended.

Put the casualty in Tredelenburg position.
Secure airway, maintain breathing, and monitor
circulation (A-B-C).
Oxygen.
Loose all clothes. Insulate casualty from cold.
In necessity, use epinephrine (adrenaline) injection
intra-muscularly.
Contact or refer to emergency medical service.
Determine the etiology, and treat them accordingly.