Shock

Shock

Shock Treatment

Self-Care at Home

If you come upon a person in shock, the initial response should be to call 911 and activate the emergency response system.

Lay the person down in a safe place and try to keep them warm and comfortable.


Medical Treatment

    EMS personnel are well trained in the initial assessment of the patient in shock. The first course of action is to make certain that the ABCs have been assessed. The so-called ABCs are:

        Airway: assessment of whether the patient is awake enough to try to take their own breaths and/or if there is there anything blocking the mouth or nose.

        Breathing: assessment of the adequacy of breathing and whether it may need to be assisted with mouth-to-mouth resuscitation or more aggressive interventions like a bag and mask or intubation with an endotracheal tube.

        Circulation: assessment of the adequacy of the blood pressure adequate and determination of whether intravenous lines are needed for delivery of fluid or medications to support the blood pressure.

    If there is bleeding that is obvious, attempts to control it with direct pressure will be attempted.

    A fingerstick blood sugar will be checked to make certain that hypoglycemia (low blood sugar) does not exist. Many people can appear to be on death's door, but wake up and remain normal when given sugar.

    In the Emergency Department, diagnosis and treatment will happen at the same time.

    Patients will be treated with oxygen supplementation through nasal cannulae, a face mask, or endotracheal intubation. The method and amount of oxygen will be titrated to make certain enough oxygen is available for the body to use. Again, the goal will be to pack each hemoglobin molecule with oxygen.

    Blood may be transfused if bleeding (hemorrhage) is the cause of the shock state. If bleeding is not the case, intravenous fluids will be given to bolster the volume of fluids within the blood vessels.

    Intravenous drugs can be used to try to bolster blood pressure (vasopressors). They work by stimulating the heart to beat stronger and by squeezing blood vessels to increase the flow within them.


Next Steps

Follow-up

Patients in shock are critically and will be admitted to an intensive care unit. Depending on the underlying condition, a variety of specialists will be involved with their care. Nurses with advanced training, respiratory therapists, and pharmacists will be added to the team of doctors assigned to one patient.

When the body is in a stressed state, it becomes more susceptible to infection. As well, having tubes in one's body for prolonged periods lead to higher infection risk. While in the hospital, the staff will be vigilant in trying to prevent nosocomial (hospital-borne) infections.

Extended nursing care is often needed if one survives shock. Rehabilitation may take a prolonged period of time as different organs recover their function. The amount of time the body was in a shock state often determines the extent of organ damage, and full recovery may never be complete. Brain injury can lead to stroke and thought impairment. Heart and lung damage can lead to significant disabilities that may include reduced exercise tolerance. Kidney damage can lead to the need for dialysis.