SHOCK

Shock

Medical shock

• VS

Psychological shock
that can occur following a traumatic or
frightening emotional event.
 What is shock?

Shock is a life-threatening medical condition as a result of

insufficient blood flow throughout the body.

Medical shock is a medical emergency and can lead to other

conditions such as lack of oxygen in the body's tissues
(hypoxia), heart attack (cardiac arrest) or organ damage.

Requires immediate treatment as symptoms can worsen

rapidly.
What is The Symptom?

Other
symptoms
The Main include:
Symptom of
• Rapid, shallow
Shock is Low breathing
Blood Pressure • Cold, clammy skin
and Rapid Heart • Rapid, weak pulse
Rate. • Dizziness or
Fainting
• Weakness
 What is The Symptom?
Depending
on the type • Eyes appear to stare
of shock • Anxiety or Agitation
the • Seizures
• Confusion or Unresponsiveness
following • Low or No urine output
symptoms • Bluish lips and fingernails
may also • Sweating
be • Chest pain
observed:
 What are The Types of Shock?

Septic shock

Resulted from bacteria multiplying in the blood and

releasing toxins.

Common causes:
• Pneumonia
• Urinary tract infections
• Skin infections (cellulitis)
• Intra-abdominal infections (such as a ruptured appendix),
• Meningitis.
 What are The Types of Shock?

Anaphylactic shock

Is a type of severe hypersensitivity or allergic

reaction.

Causes is Allergy to:

• Insect stings
• Medicines
• Foods (nuts, berries, seafood)
What are The Types of Shock?

Cardiogenic shock

Happens when the heart is damaged and

unable to supply sufficient blood to the body.

This can be the end result of a heart attack or

congestive heart failure.
What are The Types of Shock?

Hypovolemic shock

Caused by severe blood and fluid loss

• makes the heart unable to pump enough
blood/fluid to the body.
• there is not enough blood/fluid to carry
oxygen through the body.
What are The Types of Shock?

Neurogenic shock

Caused by spinal cord injury

Usually as a result of a traumatic

accident or injury.
 What is The treatment of Shock?

In general, fluid resuscitation (giving a large

amount of fluid to raise blood pressure quickly)
with an IV in the ambulance or emergency room is
the first-line treatment for all types of shock.

Epinephrine, norepinephrine, or dopamine to the

fluids to try to raise a patient's blood pressure to
ensure blood flow to the vital organs.
 What is The treatment of Shock?

Septic shock

Prompt administration of antibiotics depending

on the source and type of underlying infection.

These patients are often dehydrated and require

large amounts of fluids to increase and maintain
blood pressure.
 What is The treatment of Shock?

Anaphylactic shock

Diphenhydramine

Epinephrine

Steroid medications: methylprednisolone

H2-Blocker medication: Famotidine, Cimetidine

 What is The treatment of Shock?

Cardiogenic shock

Identifying and treating the underlying cause.

A surgical procedure called a cardiac catheterization to

unblock an artery.

Congestive heart failure may need medications to support

and increase the force of the heart's beat.

In severe or prolonged cases, a heart transplant may be the

only treatment.
 What is The treatment of Shock?

Hypovolemic shock

Fluids (saline) in minor cases.

Multiple blood transfusions in severe cases.

The underlying cause of the bleeding or fluid

loss must also be identified and corrected.
 What is The treatment of Shock?

Neurogenic shock

Most difficult to treat.

Damage to the spinal cord is often irreversible and causes

problems with the natural regulatory functions of the body.

Fuids and monitoring, immobilization (keeping the spine from

moving), anti-inflammatory medicine such as steroids, and
sometimes surgery are the main parts of treatment.
What is The Outlook for Shock?

Hypovolemic shock and

Anaphylactic shock

Respond well to medical

treatment if initiated early.
What is The Outlook for Shock?

Septic shock

A serious condition with a mortality rate of 24% to

50%

The sooner the infection is treated and fluids are

administered, the greater the chances of success.

Need specific protocols to identify and

aggressively treat septic shock patients.
What is The Outlook for Shock?

Cardiogenic shock

Has a poor prognosis, with only 1/3 of patients

surviving.

Because this type of shock results from injury or

dysfunction of the heart, it is often difficult to
treat and overcome.
What is The Outlook for Shock?

Spinal shock

Has a very poor prognosis.

Because the spinal cord mediates so

many important bodily functions.
 Special Note

For

Anaphilactic Shock
 Anaphilactic shock

Patient Related:
• Insect bites
• Food Ingestion
Iatrogenic
• Medication: Oral/IM/IV
• Radiologic Contrast
 Anaphilactic Shock

Detailed anamnesis

Informed consent

Emergency medications, fluids, Oxygen, equipments

are ready and adequate in numbers and variations.

Keep perform a professional calmness and execution.

 The Patient Is Respoding
Maintain Airway, Breathing, Circulation

Adrenalin
• Adult 0,3 – 0,5 mg SC/IM/IV
• Pediatric 0,01 mg/KgBW
• Can be repeated every 5 – 10 minutes
Aminophilin
• 5 mg/KgBW in 20 minutes
• 0,4 – 0,9 mg/KgBW/Hour
 The Patient Is Responding

If the patient's condition improved,

monitor for at least 4 hours before
discharge.

If the patient's condition is not improving,

try to stabilize the patient and refer to a
better fascilitated medical institution
a.s.a.p
 The Patient Is Not Responding

Maintain Airway, Breathing, Circulation

Perform BLS, ATLS, ACLS

Stabilize the patient

Refer to ICU for prolonged life support

Most of all, explain to the patient's famlily about the

situation
Thank You