Shock as a State of Sudden Health Threat PDF

Shock as a state of sudden health threat Piotr Szwedziński 1  Shock – what is it? Shock is caused by disturbances in tissue flow, leading to hypoxia, insufficient nutrition and removal from the cell metabolic products. The shoc...

Shock as a state of sudden health threat Piotr Szwedziński 1  Shock – what is it? Shock is caused by disturbances in tissue flow, leading to hypoxia, insufficient nutrition and removal from the cell metabolic products. The shock effect is anaerobic metabolism,accumulation lactic acid, cell damage and death. 2  PATHOPHYSIOLOGY OF SHOCK: Regardless of the cause, the consequence of each shock is metabolic poisoning of the body Oxygen deficit at the cell level is a direct cause of cell metabolism disorders Switching metabolism to anaerobic reactions leads to the accumulation of acidic metabolites of these reactions and the symptoms of metabolic acidosis. The basic symptom is cardiopulmonary collapse Improving tissue oxygenation is the main goal of shock therapy!! 3  Types of shocks Hypovolemic - is a consequence of a decrease in preload, which leads to a decrease in cardiac output Distributive (relatively hypovolemic) – occurs as a result of a significant decrease in vascular resistance ü Septic ü Anaphylactic ü Neurogenic Cardiogenic - caused by acute heart failure as a pump, manifested by reduced cardiac output 4  PHASES OF SHOCK DEVELOPMENT: Early shock (compensated) - At this stage, the body's compensatory mechanisms are still efficient - symptoms may be weakly expressed Intermediate shock (progressive) - compensatory mechanisms no longer ensure proper oxygenation of organs, tissue functions are impaired (mainly nervous tissue). The following occurs: increased heart rate, increased breathing, decreased blood pressure Late shock (irreversible) - end-stage circulatory system failure, metabolic poisoning of the body, leads to death 5  Symptoms of shock Specific – related to the shock factor (cause) Non-specific – identical for each shock 6  Non-specyfic symptoms of shock Cold and pale skin - constriction of skin blood vessels (centralization of circulation - protection of the most important organs) Consciousness disorders - decreased blood flow through cerebral vessels (impaired function of nervous tissue) Fast and deep breathing, gradually becoming shallower - a decrease in blood flow is perceived by the body as a decrease in oxygen concentration, at the same time, the respiratory muscles are increasingly poorly supplied with oxygen and nutrients and therefore their contraction strength is impaired 7  Non-specyfic symptoms of shock Sweating - the part of the nervous system responsible for the contraction of skin vessels also innervates the sweat glands and its stimulation leads to an increase in sweat secretion Fast, weak heart rate - a decrease in circulating blood volume forces the circulatory system to increase the flow rate with poorer vessel filling Lowering blood pressure - poorer filling of the vascular system results in reduced cardiac output and lower blood pressure Reduction in body temperature - decrease in the body's metabolic activity (exception - septic shock, in which body temperature increases) 8  Hypowolemic shock It is characterized by a decrease in circulating blood volume as a result of significant fluid loss due to: haemorrhage / bleeding diarrhea and vomiting along with dehydration burns fluid loss through the kidneys All non-specyfic symptoms 9  Cardiogenic shock It is acute circulatory failure caused by insufficient pumping efficiency of the heart. The heart is unable to provide blood flow that meets the metabolic needs of the tissues. Reasons: ü Loss of contractile muscle tissue in the heart (infarction) ü Acute occlusion of pulmonary circulation (pulmonary embolism, heart tumors) ü Cardiac tamponade ü Heart contusion ü Cardiac arrhythmias ü Acute rupture of the interventricular septum ü Valvular defects ü Cardiomyopathies ("enlarged heart") Specific symptoms: filled jugular veins, chest pain, shortness of breath, hemoptysis 10  Anaphylactic shock It is a systemic, severe allergic reaction It develops as a result of the release of substances in the body that dilate blood vessels and constrict the bronchi Anaphylaxis should be considered if symptoms affect two or more systems It is one of the reversible causes of cardiac arrest (sudden cardiac arrest). Specific symptoms: Local reactions (redness, hives, itching, conjunctivitis, runny nose, swelling of mucous membranes, etc.) Generalized reactions: - dilatation of blood vessels (relative hypovolemia), breathing disorders - swelling or spasm of the larynx, trachea or bronchi, wheezing 11  Septic shock It is a generalized infection of the body (most often bacterial) Reasons: bacteria, viruses, protozoa Specific symptoms: Systemic and skin symptoms: chills, fever (sometimes lower body temperature) muscle and joint pain, skin ecchymoses,skin redness, nausea, vomiting, diarrhea Cardiopulmonary symptoms: cough, shortness of breath, pain in the chest, swelling 12  Neurogenic shock Neurogenic shock accompanies injuries of the cervical or high thoracic spine and is caused by damage (interruption) of the continuity of the spinal cord Specific symptoms: hypotension, slow heart rate and warm, red skin, sometimes there is paralysis and loss of sensation 13  Procedure Make sure the place is safe. Examine the injured person and if you notice symptoms of shock, call an ambulance immediately. If you see external bleeding, immediately cover it with a pressure dressing. Stay with the injured person until the ambulance arrives. If the victim is conscious, help him lie on his back. Protect the injured person from hypothermia: do not place him on bare ground, cover him with a blanket or Emergency Blanket. Provide fresh air and administer oxygen if it possible 14 Thank you for your attention 15