Shock
En Español (Spanish Version)

Definition
Shock occurs when 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:

  • Congestive heart failure
  • Heart attack
  • Spinal cord injury
  • Sepsis—infection of the blood
  • 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
The following factors increase your chances of developing shock:

  • Pre-existing heart or blood vessel disease
  • Impaired immunity
  • Severe allergies
  • Severe trauma
  • Diabetes
Symptoms
The symptoms of shock depend on the cause.

Symptoms may include:

  • Weakness
  • Altered mental status
  • Cool and clammy skin
  • Pale or mottled skin color
  • Low blood pressure
  • Decreased urination
  • Weak and rapid pulse
  • Slow and shallow or rapid and deep breathing
  • Lackluster (dull) eyes
  • Dilated pupils
  • High or low body temperature
Symptom of Shock

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Diagnosis
A physical exam will be done.

Tests may include the following:

  • Breathing assessment
  • Blood pressure measurement
  • Heart rate monitoring
  • Other testing depending on the cause of shock
    • Blood tests and cultures
    • Electrocardiogram
    • Imaging studies
Treatment
Treatment options include the following:

Breathing Resuscitation
If you are having trouble breathing, your doctor will clear your airway. Oxygen and breathing assistance may be provided if you need it.

Optimizing Blood Pressure and Heart Rate
You will receive an IV for fluids and/or blood transfusions. These will stabilize your blood pressure and heart rate.

Insertion of IV for Transfusion or Medications

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Medications
You may be given vasopressor medications. These constrict your blood vessels to increase blood pressure. Drugs may also be used to increase your heart contractions. Other medications may be used depending on the underlying cause.

Prevention
To help reduce your chances of getting shock, take the following steps:

  • Prevent or control heart or vascular disease.
  • Avoid activities that put you at risk of falls or other injuries.
  • Carry an epinephrine pen with you if you have a severe allergy.
  • Manage conditions, such as diabetes, as advised by your doctor.



RESOURCES:
American College of Emergency Physicians

National Heart, Lung, and Blood Institute

CANADIAN RESOURCES:
Canadian Association of Emergency Physicians

Canadian Red Cross

References:
Hypovolemic shock. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated December 3, 2013. Accessed January 7, 2014.

The signs of hypovolemic shock. Health Guidance website. Available at: http://www.healthguidance.org/entry/12784/1/The-Signs-of-Hypovolemic-Shock.html. Accessed January 7, 2014.

What is cardiogenic shock? National Heart, Lung, and Blood Institute website. Available at: http://www.nhlbi.nih.gov/health/health-topics/topics/shock/printall-index.html. Accessed January 7, 2013.

Last Reviewed December 2013



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