Shock is a life-threatening condition with a variety of underlying causes. It is characterized by inadequate tissue perfusion that,if untreated, results in cell death.
Shock can best be defined as a condition in which systemic blood pressure is inadequate to deliver oxygen and nutrients to support vital organs and cellular function (Mikhail, 1999)
PATHOPHYSIOLOGY
In shock, the cells lack an adequate blood supply and are deprived of oxygen and nutrients; therefore, they must produce energy through anaerobic metabolism. This results in low energy yields from nutrients and an acidotic intracellular environment. Because of these changes, normal cell function ceases The cell swells and the cell membrane becomes more permeable,allowing electrolytes and fluids to seep out of and into the cell.
The sodium-potassium pump becomes impaired; cell structures,primarily the mitochondria, are damaged; and death of the cell results.
Types of Shock
Septic shock results from bacteria multiplying in the blood and releasing toxins. Common causes of this are pneumonia, intra-abdominal infections (such as a ruptured appendix) and meningitis.
Anaphylactic shock is a type of severe hypersensitivity or allergic reaction. Causes include allergy to insect stings, medicines or foods (nuts, berries, seafood) etc.
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.
Hypovolemic shock is caused by severe blood and fluid loss, such as from traumatic bodily injury, which makes the heart unable to pump enough blood to the body.
Neurogenic shock is caused by spinal cord injury, usually as a result of a traumatic accident or injury.
Signs and Symptoms of Shock
Low blood pressure is the key sign of shock.
Symptoms of all types of shock include:
Causes of Shock
There are several underlying causes of shock. Often, a case of shock involves two or all three of these types of underlying problems. These include:
There is not enough fluid in the bloodstream. This kind of shock is called hypovolemic (hy-po-vo-LEEM-ik) shock. It can be caused by heavy bleeding from an injury, such as a gunshot wound or wounds suffered in a car crash. It also can be caused by severe bleeding from a medical condition, such as an aortic aneurysm * or bleeding stomach ulcers. It can also occur if a person loses large amounts of fluids other than blood. That can happen, for instance, if a person has severe vomiting and diarrhea or has been badly burned over a large part of the body.
The blood vessels dilate (expand) too much. If this happens, blood pressure (the pressure within the blood vessels) can become so low that not enough blood is pushed out to reach vital tissues. The most common example of this kind of shock is septic (SEP-tik) shock, which is caused by a severe bacterial infection.
The heart fails to pump the blood strongly enough. This is called cardiogenic (kar-dee-o-GEN-ik) shock. It can be caused by many heart problems including a heart attack, an abnormal heart rhythm, a blood clot in the heart, or a buildup of fluid around the heart that presses on the organ, or by severe damage to a heart valve.
Shock can best be defined as a condition in which systemic blood pressure is inadequate to deliver oxygen and nutrients to support vital organs and cellular function (Mikhail, 1999)
PATHOPHYSIOLOGY
In shock, the cells lack an adequate blood supply and are deprived of oxygen and nutrients; therefore, they must produce energy through anaerobic metabolism. This results in low energy yields from nutrients and an acidotic intracellular environment. Because of these changes, normal cell function ceases The cell swells and the cell membrane becomes more permeable,allowing electrolytes and fluids to seep out of and into the cell.
The sodium-potassium pump becomes impaired; cell structures,primarily the mitochondria, are damaged; and death of the cell results.
Types of Shock
Septic shock results from bacteria multiplying in the blood and releasing toxins. Common causes of this are pneumonia, intra-abdominal infections (such as a ruptured appendix) and meningitis.
Anaphylactic shock is a type of severe hypersensitivity or allergic reaction. Causes include allergy to insect stings, medicines or foods (nuts, berries, seafood) etc.
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.
Hypovolemic shock is caused by severe blood and fluid loss, such as from traumatic bodily injury, which makes the heart unable to pump enough blood to the body.
Neurogenic shock is caused by spinal cord injury, usually as a result of a traumatic accident or injury.
Signs and Symptoms of Shock
Low blood pressure is the key sign of shock.
Symptoms of all types of shock include:
- Rapid, shallow breathing
- Cold, clammy skin
- Rapid, weak pulse
- Dizziness or fainting
- Weakness
Depending on the type of shock the following symptoms may also be observed:
- Eyes appear to stare
- Anxiety or agitation
- Confusion or unresponsiveness
- Low or no urine output
- Bluish lips and fingernails
- Sweating
- Chest pain
Causes of Shock
There are several underlying causes of shock. Often, a case of shock involves two or all three of these types of underlying problems. These include:
There is not enough fluid in the bloodstream. This kind of shock is called hypovolemic (hy-po-vo-LEEM-ik) shock. It can be caused by heavy bleeding from an injury, such as a gunshot wound or wounds suffered in a car crash. It also can be caused by severe bleeding from a medical condition, such as an aortic aneurysm * or bleeding stomach ulcers. It can also occur if a person loses large amounts of fluids other than blood. That can happen, for instance, if a person has severe vomiting and diarrhea or has been badly burned over a large part of the body.
The blood vessels dilate (expand) too much. If this happens, blood pressure (the pressure within the blood vessels) can become so low that not enough blood is pushed out to reach vital tissues. The most common example of this kind of shock is septic (SEP-tik) shock, which is caused by a severe bacterial infection.
The heart fails to pump the blood strongly enough. This is called cardiogenic (kar-dee-o-GEN-ik) shock. It can be caused by many heart problems including a heart attack, an abnormal heart rhythm, a blood clot in the heart, or a buildup of fluid around the heart that presses on the organ, or by severe damage to a heart valve.
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Unknown - Thursday 7 April 2011
