⚠️

Understanding Different Types of Shock

Apr 16, 2025

View transcript

Lecture on Shock

Overview of Shock

  • Definition: Shock is a critical condition characterized by decreased tissue perfusion leading to organ failure and potentially death.
  • Key Sign: Severely low blood pressure.
  • Mnemonic: S for Shock, S for Severely low blood pressure.

Stages of Shock

  1. Initial Stage

    • Low oxygen in the blood, leading to anaerobic metabolism.
    • Signs and symptoms are usually absent.

  2. Compensatory Stage

    • Body compensates for low oxygen.
    • Signs: Tachycardia, increased respiratory rate (tachypnea), activation of the sympathetic nervous system, renin-angiotensin system activation.

  3. Progressive Stage

    • Failure of compensatory mechanisms.
    • Key Sign: Cold and clammy skin.

  4. Irreversible Stage

    • Progression to organ failure and death.

Types of Shock

  1. Septic Shock

    • Caused by widespread bloodborne infection.
    • Signs: Severely low blood pressure, cool clammy skin, delayed capillary refill, confusion, disorientation, high WBC count.
    • Treatment: Intravenous fluids, antibiotics.

  2. Neurogenic Shock

    • Caused by spinal cord injury (T6 or higher).
    • Signs: Bradycardia, hypotension, warm pink skin due to vasodilation.
    • Treatment: IV normal saline, monitor for autonomic dysreflexia.

  3. Hypovolemic Shock

    • Caused by low blood volume (e.g., trauma, surgery).
    • Signs: Hypotension, tachycardia, low central venous pressure.
    • Treatment: IV fluids (normal saline), maintain hemodynamic stability.

  4. Cardiogenic Shock

    • Heart fails to pump adequately.
    • Signs: Low blood pressure.
    • Treatment: Dopamine, digoxin.

  5. Anaphylactic Shock

    • Severe allergic reaction (e.g., bee sting, food allergy).
    • Sign: Hypotension and respiratory distress.
    • Treatment: Epinephrine auto-injector (repeat every 5-15 minutes if needed), followed by antihistamines and bronchodilators.

Detailed Discussion on Septic Shock

  • Pathophysiology: Systemic cytokine release causes vasodilation and fluid leakage.
  • Signs: Low blood pressure, mental status changes, high WBC count, temperature changes.

Detailed Discussion on Neurogenic Shock

  • Pathophysiology: Autonomic nervous system damage leads to parasympathetic dominance.
  • Signs: Bradycardia, hypotension, warm skin.
  • Complication: Risk of autonomic dysreflexia.

Detailed Discussion on Hypovolemic Shock

  • Key Signs: Cold clammy skin, low urine output.
  • Interventions: Lower head of bed, IV fluids before vasopressors.

Detailed Discussion on Cardiogenic Shock

  • Treatment: Dopamine and digoxin for cardiac support.

Detailed Discussion on Anaphylactic Shock

  • Key Treatment: Epinephrine is the first-line treatment.
  • Patient Education: Use EpiPen immediately; seek medical help.

General Notes

  • For Exams: Focus on key signs and interventions for each type of shock.
  • Critical Mnemonics: Remember the stages, key signs, and treatment protocols for effective management and exam preparation.

This summary captures the essential points and treatment protocols for different types of shock, providing a comprehensive guide for study and examination purposes.

Full transcript