You've surely heard the expression, “I was in shock”, referring to being very alarmed or startled. Being shocked or alarmed and being in shock are two very different things. Shock is a physiologic state, in which the body’s mechanisms to keep itself alive by regulating blood circulation are failing. Basically, a person’s blood pressure drops and their vital organs shut down, quickly leading to death.
Early signs of shock:
- rapid, weak pulse
- appearing slightly dazed or confused
Late signs of shock:
- pale, clammy (sweaty) skin
- fast, heavy breathing
- fainting or unconsciousness
The circulatory (blood) system is made up of three components: a pump (the heart), fluid (the blood), and pipes (blood vessels), which work together to keep blood pressure regulated. We classify shock into one of three categories based on what causes blood pressure to drop: pump, fluid, or pipes.
Cardiogenic shock ("beginning in the heart") – a pump problem
A functioning pump is necessary to create good pressure. In the same way, a functioning heart is necessary to get blood to all the parts of the body. Several things can prevent the heart from pumping blood effectively, most notably including heart attack, arrhythmia (abnormal heartbeat), and pulmonary embolism (blood clots in the lungs).
Hypovolemic shock ("low volume") – a fluid problem
A well-working pump can’t create good pressure if there’s no fluid in the pipes. When there’s not enough blood in the circulation, the heart can’t get the pressure high enough. Blood loss, whether internal or external, is an obvious potential cause. Dehydration and burns can also be causes, because the body will pull fluid out of the blood to keep tissue cells alive.
Distributive shock ("spread throughout") – a pipes problem
Distributive shock occurs when the blood vessels dilate (enlarge in diameter). Even though the pump is working, and there’s plenty of fluid, increasing the size of the pipes drops the pressure. Common causes of distributive shock include sepsis (infection which has spread to the bloodstream), anaphylaxis (allergic reaction), and spinal cord injury.
This information may help you understand what is causing shock in someone, but the treatment for the layperson is the same:
- Call 911. These people need emergent medical treatment, which the paramedics can provide. Do not try to drive them to the hospital.
- Lie them down, making it easier for blood to reach the brain. Elevate their legs to encourage blood to the body’s core.
- Check for consciousness (being awake) and breathing. If they are not breathing, perform CPR. The 911 call-taker can guide you through it if you don’t know how.
- If they are unconscious, but breathing, lie them on their left side in case they vomit, and watch them closely.
This is a very brief and basic explanation of shock physiology, recognition, and treatment. You can’t fix shock on your own; you can only hope to keep the person alive long enough for the paramedics to intervene. Shock can progress in just minutes or even seconds, so always err on the side of caution and never be afraid to call 911 if you think someone’s life might be in danger.
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Stay safe and be well.
Written content © Jake Schulke