Description shock
As a shock in a wide subconscious understands and identifies some psychological shock, an event that will live and who our perception and experience badly affected. From the medical point of view, however, it is not a mental illness, but organic. It is a life-threatening situation that needs to be addressed urgently. It is a hemodynamic status, a situation which concerns the bloodstream, the blood and the distribution of oxygen and nutrients to the organs and removal of relevant substances and wastes from metabolic tissues and organs.
Shock is a condition where the blood supply to tissues is not sufficient nutrients and tissue suffers from lack of oxygen, thus ischemia. Ischemia leads to very serious consequences if not timely removed the cause that caused the shock, tissue ischemia may be irreparably damaged. However, the shock body and its development, seeks to prevent, has in store some compensatory mechanisms that are activated but can not work long term. If the cause that triggered a shock, it takes a long time, compensation fails and shock deepens.
Omívání adequate tissue blood perfusion or depends on several things. Firstly, a sufficient amount of the circulating fluid, namely blood and plasma. Unless blood is not the carrier material.Secondly sufficient cardiac output. The heart is constantly and tirelessly working station, whose task is to pump blood lacking oxygen into the lungs and oxygenated from the lungs into the circulation. Failing hearts or oppressed enough to draw so much blood, how many body tissues need.And third perfusion will depend on the condition of blood circulation, consequently the state of blood vessel walls. If they are excessively stretched, the blood does not flow in them so fast enough in time with enough oxygen into the tissues. If the situation leading to ischemia and after Designate its duration will begin to happen in the cells metabolic changes that can become fatal to the cell, and she eventually dies.
Circulatory shock can be divided into several types according causes. The most common ishypovolemic shock, a shock due to loss of circulating fluid. This occurs in injuries associated with severe external or internal bleeding, with extensive burns and during prolonged dehydration caused either by lack of fluid intake, or excessive loss (repeated vomiting, severe diarrhea, excessive sweating). Shock Cardiogenic occurs in conditions where failing heart as a pump. Heart fails, an extensive attack, enough fluid nepřečerpá or suffering from some heart cardiac arrhythmias, or heart muscle with cracked. Obstructive shock is associated with mechanical compression of a healthy heart from the outside, such as cardiac tamponade or pulmonary some processes. If relatively increased circulating space by increasing the diameter of the capillaries, then the fluid though lacking and there is distributive shock. With this shock typically encountered in anaphylactic allergic shock when small blood vessels under the influence of an allergen in the body increases its diameter, the blood therein flows more slowly and will not in time where it is needed, so it is a relative deficiency. Distributive shock occurs even in severe sepsis, a condition where the organism penetrated so many bacteria that immune mechanisms mishandled discarded, and those substances which produce expanded vasculature.
symptoms of shock
The best will be monitored for hypovolemic shock, because they can be put into context with the lost volume. According to the volume of fluid loss is attained and deepen individual symptoms. The loss of 750 ml are fully compensated defense mechanisms is not dangerous, there is only a faster pulse as the heart beats rapidly under the influence of adrenaline. 750-1500 ml is a lightweight shock characterized by cold skin, sweating, mental restlessness and weakened pulse. 1500-2000 ml already accompanies a significant increase in respiratory rate (30 breaths per minute), paleness, patient little urine is pale and dopey, has a very weak pulse and blood pressure drops. Here it may damage other organs low level of oxygen, as in the kidneys, skin and digestive system decreases blood flow in favor of the heart and brain. Reduced flow authorities can not last long, however, they need nutrients and oxygen to work properly, otherwise begin to fail. The loss of 2000 ml is actually already almost certain death, the patient is unconscious, breathing heavily, illness, not palpable pulse and his heart beats up to around 140 beats per minute, blood pressure drops to fatal levels.This shock is already difficult and is associated with brain damage, and heart due to inadequate blood supply. Failure of these organs leads to death despite intensive medical care. For other types of shocks can not relate the symptoms to specific numbers, but the symptoms are the same.
Common symptoms of shock are therefore behavioral changes (mostly light, with medium and heavy losses are deepening coma), thirst (reduced circulating volume work on the penny intake of fluid in the brain), cold, sweaty skin (blood vessels in the skin are downloaded and sweat glands increasingly secrete sweat) and pulse pressure – the pressure is gradually reduced and the pulses increases, urination decreases from the beginning – initially due to low renal perfusion, and later due to their failure.
shock treatment
It depends on the type of shock and its underlying cause. In hypovolemic shock, it is necessary to complete the missing oxen watch urination and monitor the patient in the ICU. The bleeding must stop (surgery) and blood loss supplement infusion burns with sterile cover and the following plasma.In cardiogenic shock is present cardiologist and cardiac surgeon, anaphylactic shock must be monitored in the ICU septic states on infectious wards treated with antibiotics. The basic task is to prevent organ changes, or deepening, circulation ratios stabilize and remove the cause.
How to help in shock
Organism in the first phase, trying to help themselves by activating compensatory mechanisms. Of nadlevnin poured adrenaline and noradrenaline and accelerate the heart rate and constricts blood vessels. Kidneys under the influence of the hormone aldosterone retained in the body more water and sodium. Into the blood vessels is also moving water present in the cells in order to supplement the lack of volume in the blood vessels. All efforts aimed at preserving the body to maximize the flow of vital organs – the brain and heart at the expense of the intestines, kidneys and skin. If fully deployed using compensatory mechanisms fail to reverse the situation and inducing stimulus is stronger than the defenses, deepens the lack of oxygen in tissues, changes the pH (decreasing) and fails transpost substances across the cell membrane to the cell dies. Is broken thinnest part of the vascular circulation, i.e. the capillary from which the fluid escapes and coalesce them red blood cells and capillaries become blocked. This is the stage decompensation, followed by a final phase – irreversible when completely collapses circulation and resulting in death.
Help is always medical and must be immediate, it increases the possibility of survival. If the patient is bleeding, the first using a compression bandage the bleeding site. FAC wrapped pressed against the wound and the other tightly wrap around the wound. Never nezaškrcujeme limb above the wound, to more distant locations must at least some blood flow to the limb neodumřela.We hide behind the burned area with sterile square. For repeated vomiting or severe diarrhea, it is better to immediately consult a doctor, the patient usually wears any liquid hold so long that she could absorb. Heart attack and arrhythmias also belong in the hands of doctors, as well as the treatment of allergic shock or sepsis.
complications shock
In the foreground is the affection of organs that are exposed during the compensatory phase of reduced blood flow. From the intestine and the pancreas to release substances negatively affecting the contraction of blood vessels and the heart and blood circulation during prolonged violation of disturbing the intestinal wall, creating ulcers and intestinal bacteria transgress them into circulation and cause sepsis. Kidneys under insufficient oxygen supply was decreasing in blood filtration and urine formation, face up to their complete failure, which is irreversible and the kidneys are permanently damaged. Lungs reduced blood flow results in changes to the capillaries into the lung gets fluid and pulmonary edema arises worsening breathing because seriously exchange of gases from the lungs into the blood and in the opposite direction. Until the last moment is to maintain the flow of brain’s control center. The first leaves the cortex, that is most sensitive to lack of oxygen. It comes on behavioral change can occur aggression. How to oxygen deficiency deepens and prolongs the duration, they lose their function and lower levels of the brain. It comes with impairment of consciousness to complete coma and death occurs if you fail respiratory and cardiovascular center in the medulla.
Other names: Hemorrhagic shock, hemorrhage, cardiogenic shock, distributive shock, circulatory shock