Shock
Shock is a pathological condition that refers to life–threatening conditions. The concept of shock is understood as instability of vital organ systems, which can lead to the development of dangerous complications and even death. Shock occurs as a hyperactive reaction of the body to external negative stimuli.
CAUSES OF SHOCK
Depending on the type of shock, there are groups of causes that contribute to the development of such an acute condition. Reasons:
Activation of the immune system, the development of immediate type reactions.
Pronounced pain syndrome, injuries, damage to internal organs.
Blood loss, diseases of the cardiovascular system.
Violations of safety and technology during blood transfusion.
Burns, chemical and radiation injuries.
Infectious diseases, especially severe and especially dangerous infections, dehydration.
Shock is the state of the body in which all the internal forces of the body are directed to the preservation of damaged vital organs. Already in the first stage of shock, destructive changes of the nervous system are observed, over time, the central nervous system is depressed.
CLASSIFICATION OF SHOCK
There are several classifications of shock. The first in severity:
Shock of the 1st degree. Objective indicators: pulse no more than 100 per minute, blood pressure no less than 90 mmHg. The patient’s condition is assessed as moderately severe.
Shock of the 2nd degree. The pulse increases to 140 beats per minute, blood pressure drops to 70 mmHg. The patient’s condition is severe.
Shock of the 3rd degree. The pulse reaches more than 160 beats per minute, the blood pressure is less than 60 or is not determined. The patient’s condition is extremely serious.
Shock of the 4th degree. The condition is characterized as pre-diagonal. Objective indicators are practically not determined.
The diagnostic criterion of shock is considered to be according to the Algover index. The index value is calculated using the following formula – the ratio of the number of beats (pulse) to systolic pressure. Thus, the higher the Algover index, the more pronounced the degree of shock.
SHOCK IS ALSO DISTINGUISHED FOR THE FOLLOWING REASONS:
Burn shock.
Surgical shock.
Blood transfusion shock.
Traumatic shock.
Hypovolemic shock – when the volume of circulating blood changes.
Hemorrhagic shock – with massive bleeding.
Cardiogenic shock – in diseases of the circulatory system.
Septic shock – in infectious diseases.
Anaphylactic shock – with a reactive allergic reaction.
SYMPTOMS OF SHOCK
Shock is conventionally divided into two phases = erectile and torpid phases.
The erectile phase is characterized by arousal of the patient, motor activity, possibly nervous excitement up to the manifestation of aggression. At this stage, the patient may not feel pain and deny the presence of pathology, trauma, etc. Objectively: there is a rapid heartbeat, the skin is pale. The patient is conscious, breathing is shallow.
During the torpid phase, the extinction of all vital processes in the body is observed, the transition to a pre-diagonal state. The nervous system is depressed, the patient is often in a delusional, stuporous state, unconscious. Patients cease to show motor and emotional activity, become paler. The skin is cold, covered with sticky sweat. The pulse becomes thready, it is more difficult to feel, blood pressure drops, breathing becomes more irregular.
SHOCK TREATMENT
Depending on the reasons that caused such a negative response of the body, the doctor will take various measures. Of course, there is a general set of actions for all types of shock, since it is aimed at maintaining the last forces of the body.
Thus, in case of traumatic shock, the pain syndrome should be stopped first of all. If necessary, introduce hemostatic drugs, perform a reposition, apply a bandage.
In case of bleeding, a temporary stop is performed, followed by ligation and replenishment of the volume of circulating blood. In case of anaphylactic shock, glucocorticosteroids, antihistamines are immediately administered, artificial ventilation of the lungs is performed.
Next, resuscitation actions are carried out, emergency medications are used. After the stabilization of the patient’s condition, supportive therapy, intensive therapy is carried out.
