Carl R. Darnall Army Medical Center - Health Library

Shock

Definition

Shock is the inadequate blood flow threatens the function of multiple organs. Shock is a potentially life-threatening condition. The sooner it is treated, the better the outcome. If you suspect someone is in shock, call for medical help right away.

Causes ^

Some causes of shock include:

  • Heart failure
  • Heart attack
  • Spinal cord injury
  • Systemic infection—sepsis
  • Other severe infection
  • Allergic reaction
  • Poisoning
  • Loss of blood volume (hypovolemia)—this can be from severe bleeding or severe dehydration
  • Heatstroke
  • Trauma
  • Severe hypoglycemia
  • Stroke

Risk Factors ^

Factors that may increase your chances of shock:

  • Pre-existing heart or blood vessel disease
  • Impaired immunity
  • Severe allergies
  • Severe trauma
  • Diabetes

Symptoms ^

The symptoms of shock depend on the cause.

Symptoms may include:

  • Weakness
  • Altered mental status
  • Cool and clammy skin
  • Pale or mottled skin color
  • Decreased urination
  • Slow heartbeat
  • Slow and shallow or rapid and deep breathing
  • Lackluster (dull) eyes
  • Dilated pupils

Symptom of Shock
Dilated and Constricted pupil

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Diagnosis ^

A physical exam will be done.

Tests may include the following:

  • Breathing assessment
  • Blood pressure measurement
  • Heart rate monitoring
  • Other testing depending on the cause of shock
    • Blood tests and cultures
    • ECG
    • Imaging tests

Treatment ^

Treatment options include the following:

Breathing Resuscitation

If you are having trouble breathing, your doctor will clear your airway. Oxygen and breathing assistance may be provided if you need it.

Optimizing Blood Pressure and Heart Rate

You will receive an IV for fluids and/or blood transfusions. These will stabilize your blood pressure and heart rate.

Insertion of IV for Transfusion or Medications
IV_insertion

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Medications

You may be given vasopressors. These medications constrict your blood vessels to increase blood pressure. Drugs may also be used to increase your heart contractions.

Other medications may be used depending on the underlying cause.

Prevention ^

To help reduce your chances of shock:

  • Prevent or control heart or vascular disease.
  • Avoid activities that put you at risk of falls or other injuries.
  • Carry an epinephrine pen with you if you have a severe allergy.
  • Manage conditions, such as diabetes, as advised by your doctor.
RESOURCES:

American College of Emergency Physicians
https://www.acep.org

National Heart, Lung, and Blood Institute
https://www.nhlbi.nih.gov

CANADIAN RESOURCES:

Canadian Association of Emergency Physicians
http://caep.ca

Canadian Red Cross
http://www.redcross.ca

REFERENCES:

Cardiogenic shock. EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T115657/Cardiogenic-shock. Updated June 5, 2017. Accessed December 14, 2017.

Cardiogenic shock. National Heart, Lung, and Blood Institute website. Available at: https://www.nhlbi.nih.gov/health-topics/cardiogenic-shock. Updated July 1, 2011. Accessed December 14, 2017.

The signs of hypovolemic shock. Health Guidance website. Available at: http://www.healthguidance.org/entry/12784/1/The-Signs-of-Hypovolemic-Shock.html. Accessed December 14, 2017.

Last reviewed December 2017 by EBSCO Medical Review Board Marcie L. Sidman, MD  Last Updated: 12/20/2014