In an analysis of 1600 patients who presented with shock, septic shock occurred in 62%, cardiogenic shock in 16%, hypovolemic shock in 16%, other types of distributive shock in 4%, and obstructive shock in 2%. Haemorrhagic shock excessive blood loss may be due to. In this study, 263 patients with severe sepsis or septic shock were randomized on arrival to the emergency department to receive fluid resuscitation with standard goals adequate central venous pressure, blood pressure, and urine output or early goaldirected therapy egdt for a period of 6 hours. An understanding of the diff e r ences means that aggressive treatment can immediately be given to the patient. Shock is a potentially lifethreatening condition that occurs when the body is not getting enough blood flow. Shockshock syndromesyndrome shock is a condition in which the cardiovascular system fails to perfuse tissues adequately an impaired cardiac pump, circulatory system, andor volume can lead to compromised blood flow to tissues inadequate tissue perfusion can result in. In some cases a patient may have a combination of more than one types of shock, as in trauma. Management of shock definition of shock shock is a state in which there is inadequate blood flow to the tissues to meet demand. Shock is a lifethreatening circulatory disorder that leads to tissue hypoxia and a disturbance in microcirculation.
The clinical manifestations of septic shock may be fulminating and rapidly fatal. Find out the symptoms, causes, risks, and treatments for this potentially lifethreatening condition. Neurogenic shock a type of distributive shock that results from the loss or suppression of sympathetic tone causes massive vasodilatation in the venous vasculature, venous return to heart, cardiac output. Hypovolemic shock is the most common type of shock and involves a large deficiency of intravascular fluid volume. If the underlying cause is corrected, the patient will recover with little to no residual effects. It is a state of acute circulatory failure in which the cardiac output unable to maintain tissue perfusion for nutrition, oxygenation and waste disposal. Quick and dirty guide to shock shock is a complex group of physiological abnormalities that comes from a variety of diseases and injuries.
There are many different causes of shock, which are classified into cardiogenic shock e. Shock is a clinical syndrome characterised by hypotension i. Even though it is globally recognised as one of the commonest causes of mortality, the underlying causes are not homogenous across diverse. Shock critical care medicine merck manuals professional edition. Shock its types and management linkedin slideshare. The presentation may be cryptic, as in the patient with compensated heart failure, or obvious as in the ultimate shock state of cardiac arrest. While the general signs for all types of shock are low blood pressure, decreased. The mucus membrane colour may be bright red and animal may be hyperthermic. Definition, classification, etiology, and pathophysiology of shock in. In a patient presenting with hypotension and concern for shock, the clinician must evaluate for diagnostic clues to the underlying cause and type of shock.
A severe allergic reaction can lead to anaphylactic shock. Shock is a lifethreatening condition that occurs when the body is not getting enough blood flow. Hemorragic shock,causes,signs and management, everything. Shock is defined as a state of acute energy failure due to inadequate glucose substrate delivery, oxygen delivery, or mitochondrial failure at the cellular level. Shock is a condition resulting from inability of the circulatory system to provide the tissues requirements from oxygen and nutrients and to remove metabolites. Ebraheims educational animated video describes information associated with general trauma shock. Shock is the state of insufficient blood flow to the tissues of the body as a result of problems with.
Obstructive shock an overview sciencedirect topics. Shk 2 shock always a symptom of its cause abnormally low organ perfusion usually associated with decreased blood pressure signs of organ. Spinal cord injury above t6 neurogenic is the rarest form of shock. Treatment of shock is based on the likely underlying cause. Shock is a medical emergency and requires immediate treatment as symptoms can worsen rapidly. Pediatric shock recognition, classification and initial management critical concepts course recognition and classification initial management of shock final thoughts recognize compensated shock quickly have a high index of suspicion, remember tachycardia is an early sign. Initial management of sepsis and septic shock involves consideration of. Diagnosis and management of shock in the emergency.
Shock, in physiology, failure of the circulatory system to supply sufficient blood to peripheral tissues to meet basic metabolic requirements for oxygen and nutrients and the incomplete removal of metabolic wastes from the affected tissues. Hypovolemic shock is the result of blood loss or significant water and salt loss fluid and electrolyte loss. Perspectives on aetiology, pathophysiology and management. More than 1 million cases of shock are estimated to present to u. Surviving sepsis guidelines ssg dellinger et al, 20, appear to be religiously followed in some parts of the world, however they are not usually explicitly followed in australia and new zealand. Diagnosis and management of sepsis and septic shock. Shock and hypotension often coexist, but a normal blood pressure does not exclude the diagnosis of shock. Find powerpoint presentations and slides using the power of, find free presentations research about management of shock ppt.
Lack of blood flow means the cells and organs do not get enough oxygen and nutrients to function properly. For example, shock is typically associated with hypotension and reduced cardiac output, but it can also occur with normal blood pressure and an increased cardiac output. In daily practice, however, focusing on the main goal to provide adequate oxygen delivery thereby. View and download powerpoint presentations on management of shock ppt. Shock management for cardiosurgical icu patients the. Shock should we emergently revascularize occluded coronaries for cardiogenic shock and iabp shock ii intraaortic balloon pump in cardiogenic shock ii trials are presented in table 1. This may be followed by confusion, unconsciousness, or cardiac arrest, as complications worsen. Shock is the final manifestation of a complex list of etiologies and could be fatal without timely management. Anaphylactic shock is caused by an allergic reaction.
The glucose in the blood may also drop, rather than increasing. Shock is a lifethreatening medical condition as a result of insufficient blood flow throughout the body. Specific searches were performed for types of shock includ ing the terms. Shock is the state of insufficient blood flow to the tissues of the body as a result of problems with the circulatory system. Worldwide, shock is a leading cause of morbidity and mortality in the pediatric population. Later the septic shock adds up and worsens the condition. Shock is common and the most important cause of death among surgical patients. Diagnosis and management of sepsis and septic shock martin d. There are five main types of shock the body can experience. There are many types of shock and this is not only a result of excessive blood loss which is a common misconception. Introduction to management of shock for junior icu trainees and medical students.
Definition shock is a physiologic state characterized by systemic reduction in tissue perfusion, resulting in decreased tissue oxygen delivery. Shock is a lifethreatening, generalised form of acute circulatory failure with inadequate oxygen delivery to, and consequently oxygen utilisation by, the cells. When large numbers of cells are bypassed by oxygenated blood, an imbalance in oxygen demand and delivery develops that can lead to shock. Psychologic shock is caused by a traumatic event and is also known as acute stress disorder. Early warm shock in this type there is cutaneous vasodilatation. It is best defined as inadequate perfusionblood flow to the bodys peripheral tissues causing lifethreatening hypoperfusion not enough o2 reaching the cells. Shock is defined as the widespread hypoperfusion of the tissues due to a reduction of the blood volume or cardiac output or redistribution of the blood resulting in an inadequate effective circulatory volume. Perspectives on aetiology, pathophysiology and management of shock in african children. It is a state of acute circulatory failure in which the cardiac output unable to maintain tissue perfusion for nutrition.
Cardiogenic shock occurs as a consequence of heart muscle or heart valve disease. It occurs due to the serious assault on the body hemostasis. Medical shock is a medical emergency and can lead to other conditions such as lack of oxygen in the bodys tissues, heart attack cardiac arrest or organ damage. Cardiogenic shock is the result of failure of the cardiovascular organs, particularly the heart. Septic shock is the only type of shock where the rules can change. Results the most diagnostic causes of unstability in polytrauma patients by rush are hypovolemic shock 64%, followed by obstructive shock 14%, distributive shock 12% and cardiogenic shock. Shock is a lifethreatening condition of circulatory failure, causing. Initial symptoms of shock may include weakness, fast heart rate, fast breathing, sweating, anxiety, and increased thirst. Shock symptoms, diagnosis and treatment bmj best practice.
The term shock may refer to a psychologic or a physiologic type of shock. Shock and hypotension often coexist, but a normal blood pressure does. Unfortunately, shock may present in a variety of ways, so diagnosis isnt always so simple. The wide range of etiologies can contribute to each of these categories and are manifested by the final outcome of shock. However, these are not exclusive, and many patients with circulatory failure have a combination of more than one form of shock multifactorial shock table 1. If the body is unable to compensate the body will enter the progressive stage of shock lewis, heitkemper, dirksen, obrien, bucher 2007.
Slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. Shock knowledge for medical students and physicians. Ppt shock powerpoint presentation free to download. The management of the patient in shock requires skills in patient assessment, monitoring of vital signs, an understanding of. When the burn is more than 25% of the body surface area leading to capillary leakage and hypovolemia. Common triggers are medications such as penicillin, latex, bee stings, and foods such as nuts or shellfish. Shock in cardiosurgical intensive care unit icu patients is a serious condition with a high morbidity and mortality.