Shock is a dangerous condition when blood pressure drops drastically so that the organs and tissues of the body do not get enough blood flow. This condition is usually a complication of another disease or condition.
Blood serves as a supplier of substances that are important to body tissues, such as nutrients and oxygen. In a state of shock, there is a disturbance that causes the heart and blood vessels to not be able to flow blood to the body's tissues optimally.
As a result, the supply of nutrients and oxygen needed for the body's tissues and organs to function normally becomes blocked. This condition can occur simultaneously in all organs so that the effects can be fatal, especially if not treated immediately.
Cause of Shock
There are three factors that contribute to the occurrence of shock, namely:
- Inability of blood vessels to drain blood
- Inability of the heart to pump blood
- Lack of blood to flow
There are various diseases or conditions that can cause any of the above and trigger shock. The following are causes of shock by type:
- Cardiogenic shock
Cardiogenic shock is caused by a disorder of the heart, such as a heart attack or heart failure.
- Neurogenic shock
Neurogenic shock is caused by a disturbance in the nervous system. This condition usually occurs due to spinal cord injury due to an accident while driving or doing activities.
- Anaphylactic shock
Anaphylactic shock is caused by allergies to insect bites, drugs, or food and drink.
- Septic shock
Septic shock is caused by an infection that enters the bloodstream (sepsis) and triggers inflammation or inflammation.
- Hypovolemic shock
Hypovolemic shock is caused by the loss of large amounts of fluid or blood, for example from diarrhea, bleeding in an accident, or vomiting blood.
Shock risk factors
Shock can be experienced by anyone. However, there are several risk factors that can increase the occurrence of shock, namely:
- Cardiogenic shock is more at risk for the elderly (elderly), people with a history of heart attacks, people with coronary heart disease, and people with diabetes or hypertension.
- Neurogenic shock is more likely to occur in someone who has had a spinal cord injury or taken drugs that affect the nervous system
- Anaphylactic shock is more likely to occur in someone who has had anaphylactic shock before, has asthma or certain allergies, or has a family history of anaphylactic shock.
- Septic shock is more common in people who have had surgery or have been in hospital for a long time, have diabetes, have used a catheter or breathing apparatus, or are malnourished.
- Hypovolemic shock is more likely to occur in the elderly (elderly) and patients with diseases that can cause bleeding
Symptoms of Shock
Decreased supply of nutrients and oxygen due to shock can result in several symptoms, such as:
- Hard to breathe
- Sweaty, cold and pale skin
- Heart palpitations, and the pulse becomes weak
- Dizzy
- Weak
- Fainted to lose consciousness
- Blue lips and fingernails (cyanosis)
In addition, based on the cause, each type of shock can cause the following additional symptoms:
- Cardiogenic shock can cause symptoms of chest pain or heaviness, pain radiating to the shoulders and arms, nausea, and vomiting
- Neurogenic shock can cause symptoms of weakness, blank stares, and decreased body temperature (hypothermia).
- Anaphylactic shock can cause swelling of the tongue or lips, difficulty swallowing, runny nose and sneezing, and tingling.
- Septic shock can cause symptoms of fever, chills, confusion, and anxiety
- Hypovolemic shock can cause symptoms of diarrhea, vomiting, bleeding, anxiety, and confusion
When to go to the doctor
Call the ambulance service immediately if anyone around you appears to be in shock. Shock is a condition that can worsen quickly so it is very dangerous and can be life-threatening. Therefore, treatment must be done as soon as possible to prevent complications, even death.
If you have an illness that can cause shock, consult your doctor and have regular check-ups to prevent shock.
Shock Diagnosis
Shock is an emergency that requires a rapid diagnosis so that treatment can be done immediately. The doctor will look at the symptoms that appear, and check for clinical signs, such as a fast and weak heart rate, rapid breathing, and low blood pressure.
Furthermore, the doctor will immediately provide initial treatment to improve the patient's condition to become stable. After that, a new follow-up examination will be carried out to detect the cause and type of shock suffered by the patient.
A series of checks that can be carried out are:
- blood test
- Allergy test
- Scanning tests, such as ultrasound, CT scan, or MRI
- Other tests based on the cause of shock, such as electrocardiography for cardiogenic shock, or endoscopy for hypovolemic shock
Shock Treatment
Shock is a dangerous condition. Call a doctor or call an ambulance immediately if you see someone who is suspected of being in shock. While waiting for help to arrive, perform first aid on the patient.
The following is the first aid that can be done when seeing a patient suspected of experiencing shock:
- Lay the patient down slowly.
- Do not move or move the patient unnecessarily.
- Loosen or remove tight clothing.
- Check pulse and heart. If the patient is not breathing or there is no pulse, perform cardiopulmonary resuscitation (CPR).
- Give the patient a blanket, to warm and soothe him.
- Do not give the patient anything to drink or eat.
- Immediately give epinephrine in the form of autoinjector if the shock is caused by an allergy and if the patient is found to be carrying this injection.
- Cover and gag the bleeding area with a towel or cloth if the person is bleeding.
- If the patient vomits or bleeds from the mouth, change the position to the side to avoid choking.
When treated by medical personnel, the patient will receive emergency treatment until his condition is stable. Actions that can be taken include:
- Intravenous fluids (fluid resuscitation)
- Administration of oxygen
- Opening of the airway
- Administration of drugs to restore blood pressure and regulate heart rate, such as norepinephrine
Further treatment will be carried out based on the type of shock and the cause of the shock, namely:
- Hypovolemic shock
Hypovolemic shock is treated with blood transfusions. However, if hypovolemic shock is caused by bleeding, the doctor may perform surgery to stop the bleeding once the patient's condition has stabilized.
- Cardiogenic shock
Cardiogenic shock is treated with drugs that function to improve the heart's pumping. These types of drugs are dopamine or dobutamine.
Several surgical procedures can also be performed to treat the causes of cardiogenic shock, such as angioplasty or surgery bypass, to treat shock caused by a heart attack.
- Anaphylactic shock
Anaphylactic shock is treated with administration of epinephrine injections and antihistamines, which work to relieve allergic reactions.
- Neurogenic shock
Neurogenic shock is treated by protecting the nerves from further damage, sometimes with the help of anti-inflammatory drugs such as corticosteroids. If possible, the doctor will also perform surgery to repair the damage to the nervous system.
- Septic shock
To treat the infection, your doctor may give you antibiotics, antivirals, or antifungals, depending on the type of infection. Surgery can also be performed to treat the source of the infection.
Shock Complications
If not treated as quickly as possible, shock can lead to a lack of oxygen (hypoxia) throughout the body. This of course can damage the tissues and organs of the body, giving rise to complications. Some of the complications that can arise from shock include:
- Permanent organ damage, such as kidney, liver, or heart damage
- Damage to the brain
- Gangrene
- Heart attack
- Death
Shock Prevention
Shock can be prevented by avoiding the disease that triggers it. Some things you can do to prevent shock are:
- Perform regular heart checks and take medication regularly for people with heart disease, to avoid cardiogenic shock
- Treat signs of infection as quickly as possible to avoid septic shock
- Implement safe driving behavior to avoid neurogenic shock due to spinal cord injury
- Be aware of and avoid allergenic triggers that have the potential to cause anaphylactic shock and always carry epinephrine in the form of autoinjector (shaped like a pen)