Shock: Treatment, Diagnosis & More

When most of us hear the term ‘shock’, we always come up with the image of someone experiencing psychological shock after a traumatic experience in their life. While this condition is also serious and warrants immediate medical attention, other equally severe types of shock affect humans physiologically. 

Your body’s organs depend on oxygen to function properly. When your body experiences severe trauma, the result is a cascade of events that, when they happen together, constitute shock. During the episode, the oxygen demand exceeds the supply, affecting the functioning of the organs. When the obstruction of the blood flow to the organs is left untreated, it will become fatal. 

The effects of shock can be reversed in its early stages. However, a significant delay in diagnosing and initiating the term will lead to irreversible damage. Let’s explore the different types of shock and how to diagnose and manage them!

Understanding Shock

Shock is a life-threatening condition in which the blood flow to your body organs is impeded for various reasons. This creates a situation in which oxygen and nutrients cannot reach the body’s cells. It leads to hypoxia (lack of oxygen) at the cellular level, which causes cell death. When more cells in a part of the body die, the affected individual dies.

Types of Shock – Diagnosis and Management

There are several types of chock, all with their causes and concerns. In some cases, the symptoms will be mild, while in other types, the symptoms will progress so quickly that there will be barely time for healthcare providers to respond. Whatever the case, proper diagnosis and treatment are necessary to control the condition. Read on to explore the types of shock, diagnosis, and treatment for specific situations. 

Cardiogenic Shock

Cardiogenic shock occurs when the heart cannot pump adequate blood to meet the body’s needs. It ultimately leads to decreased blood pressure and inadequate perfusion of vital organs. When left untreated, the condition can lead to multiorgan failure and health problems. The condition affects only 10% of patients who are diagnosed with myocardial infarction. 

Diagnosis of Cardiogenic Shock 

Cardiogenic shock is often diagnosed with a combination of physical examination and a series of diagnostic tests. During the physical examination, your healthcare provider will assess your body for specific symptoms, including low blood pressure, cold and clammy skin, abnormal heart rhythm or heart murmur.  

The diagnostic test includes ECG (Electrocardiogram), Echocardiogram and blood test to find the underlying cause of the treatment. 

Cardiogenic Shock Treatment 

The primary goal of cardiogenic shock treatment is to improve blood flow to the vital organs and restore normal heart function. The treatment may include one or a combination of the following.

• Medication: Your healthcare professional can prescribe medications such as inotropes and vasopressors to increase heart function and optimize blood pressure. These drugs act on the cardiomyocytes (cells in the heart muscles) and help them to contract with adequate power, depending on your condition. Diuretics might also be prescribed to reduce excess fluid in the body.
• Oxygen Therapy: Your healthcare professional might suggest supplemental oxygen to improve the delivery rate of oxygen to vital organs and tissues throughout the body. 
• Mechanical Support: In some cases, mechanical devices such as ventricular assist devices or intra-aortic balloon pumps may be used to support heart functions.
• Revascularization: If a cardiac arrest induces cardiogenic shock, revascularization procedures, including PCI (Percutaneous coronary intervention) or CABG (Coronary Artery Bypass grafting), will be performed to store blood flow to the damaged area of the heart.
• Surgery: In rare cases, surgery might be necessary to repair or replace the damaged heart valves or to address any structural abnormalities. 

Read more: What is Cardiac Massage & Type of Cardiac Massage Technique (cprcare.com)

Preventive Measures for Cardiogenic Shock

Preventing cardiogenic shock involves addressing the underlying cause of the condition. It clues into managing the risk factors for heart diseases like diabetes or high blood pressure and making certain lifestyle modifications. The preventive measures include,

• Avoid Smoking: Quitting smoking will be the most effective strategy in lowering your risk for cardiac arrest and, therefore, preventing the occurrence of cardiogenic shock.
• Maintain a healthy BMI: Obesity exacerbates hypertension, heart disease, and diabetes. Therefore, make sure to maintain a healthy Body Mass Index to improve your blood pressure and cholesterol levels.
• Diet Modifications: Cut down on sugar consumption to avoid unnecessary calories that lead to excess weight and affect cardiac function. Also, limit the intake of cholesterol and saturated fat to avoid the occurrence of cardiovascular diseases. 
• Regular Physical Activity: Engaging in regular physical activity will decrease blood pressure and improve the condition of your blood vessels. 

Anaphylactic Shock

Anaphylactic shock is a complication of anaphylaxis – a severe, life-threatening allergic reaction that happens after exposure to an allergen. The condition occurs when an immune system perceives a substance (Allergen) as a threat and overreacts. As a result, your immune system releases certain chemicals into your body that trigger symptoms like itching, skin rash, stomach pain, vomiting, and trouble breathing. The condition, when left untreated, will cause a sudden drop in your blood pressure and swollen, narrowed airways. 

Diagnosis of Anaphylactic Shock

When a person with anaphylactic shock arrives at the hospital, they can expect the following: 

• The doctor will take a quick medical history and perform a physical examination to evaluate their vital signs, including heart rate, blood pressure, and respiratory rate. 
• They will also look for signs of the condition, including hives, flushed or clammy skin, a swollen tongue, wheezing, and the visible struggle of troubled breathing. 
• They might ask you what allergy you have been exposed to, how quickly symptoms develop, and whether you have administered epinephrine. 
• While not always necessary, blood tests might be prescribed to measure the histamine and mast cell tryptase (MCT) levels in your bloodstream to confirm the diagnosis of the condition. 

Treatment for Anaphylactic Shock

 It is important to administer the primary anaphylactic shock treatment at the first sign of a severe allergic reaction. The immediate treatment will subside the symptoms and avoid the occurrence of any severe health conditions. The treatment for anaphylactic shock includes: 

• Epinephrine: Epinephrine is the only effective treatment for anaphylactic shock. It reverses the shock by opening the airways and raising the blood pressure. It is usually administered as an auto-injector or as a shot to relieve the symptoms in a few minutes. Your healthcare provider might administer an additional dose of epinephrine intravenous (IV) according to your condition.
• Medications: Certain medications will be prescribed in addition to epinephrine to manage the symptoms. These include:

1. Antihistamines: Antihistamines treat itching, hives, and swelling caused by the condition. They aid in relieving the condition and prevent it from worsening.
2. Corticosteroid: Corticosteroids reduce inflammation and prevent further damage to the body. They also help reduce the severity of the allergic reaction.
3. Bronchodilators: These medications aid in open, narrow airways, making your breathing easier. 

• Breathing Treatment: In severe cases of anaphylaxis, breathing treatments, such as using a nebulizer or inhaler to open the airways and relieve symptoms, will be prescribed.
• Supportive Care: People who experience anaphylactic shock require a hospital stay to monitor their condition regularly. It allows healthcare professionals to monitor your vital signs, including heart rate, respiratory rate, blood-oxygen level, and blood pressure, to ensure continued, successful recovery. The supportive care treatment inches,

1. Supplemental Oxygen: Oxygen therapy aids in improving blood oxygen levels in people with troubled breathing.
2. Intravenous Fluids: Administering intravenous fluids will help prevent dehydration and its associated complications, including seizures or dizziness.
3. Airway Management: If your airways are severely swollen and narrow, intubation may be essential to help you breathe properly. 

Preventive Measures for Anaphylactic Shock

Avoiding exposure to allergens is the best way to prevent anaphylactic shock. Here are some strategies for reducing the risk of an allergic reaction.

• Avoid Known Allergens: Identify and avoid foods, medications, or even environments that may induce an allergic reaction. If necessary, you can also undergo an allergy blood test to find any possible allergens.
• Carry an Epinephrine Auto-Injector: Epinephrine is the first-line treatment for anaphylactic shock. Therefore make sure to have an auto-injector in hand to prevent the reaction from progressing into life-threatening conditions. You can discuss the right dosage and type for your needs with your healthcare provider. 
• Spread Awareness: Learn about the signs and symptoms of anaphylactic shock so that you can recognize the condition quickly. Make sure to educate yourself and your family on the signs, symptoms, and treatments of the condition.
• Wear Medical Identification: If you have allergies, wear a medical identification bracelet or necklace so that people will be aware of your allergies and administer the accurate treatment if you have been exposed to the episode of anaphylaxis.

Neurogenic Shock

Neurogenic shock is a rare but potentially life-threatening condition caused by damage to the brainstem or spinal cord. It occurs when the normal balance of the autonomic nervous system is disrupted, leading to blood vessel dilation and a decrease in blood pressure. 

Immediate administration of neurogenic shock treatment will stabilize the patient’s airway, breathing, and circulation and repair any underlying damage to the nervous system. 

Diagnosis of Neurogenic Shock

Some common diagnostic tests for neurogenic shock include blood tests to detect anemia, electrolyte imbalances, and organ functions. The diagnosis also involves imaging tests like CT (computerized scan) and MRI (Magnetic Resonance Imaging) to identify any structural damage or spinal cord abnormality and neurological exams to assess sensory and motor function and reflexes. 

Treatment of Neurogenic Shock

The primary goal of managing neurogenic shock is to restore the adequate perfusion of the body’s tissues by elevating blood flow and improving oxygen delivery rate. It can be done by restoring cardiac output, maintaining adequate blood pressure, and ensuring proper tissue oxygenation. The treatment of the condition requires a multidisciplinary approach involving various parameters.

• Immobilization: If the patient has a diagnosed spinal cord avenged, traction will be required to stabilize the spine and bring it to the proper alignment.
• IV Fluids: IV fluids are administered as a primary therapy to treat low blood pressure. The therapy improves the fluid levels in the veins to assist in stabilizing the blood pressure.
• Vasopressors: Vasopressors can assist in tightening the blood vessels and optimize blood pressure levels. 

Preventive Measures of Neurogenic Shock

While it is impossible to prevent all instances of neurogenic shock, you can take some preventive measures to reduce the risk. Some effective strategies include,

• Wearing appropriate protective gear while engaging in strenuous sports or any other high-risk physical activities.
• Avoid falls by being aware of the environment and assessing safe routes free of obstacles.
• Practice safe driving habits like wearing seat belts and not driving under the influence of alcohol consumption or drugs.
• Appropriate management of chronic medical conditions such as diabetes, hypertension, and heart disease can increase the risk of spinal cord injury or stroke. 

Shock Treatment for Depression

Shock, in most cases, is also considered to be a medical emergency that is characterized as a sudden and severe emotional upset in an individual after experiencing a traumatic incident. When not treated immediately, the condition might induce depression. 

When medication fails to ease the symptoms of such induced clinical depression, there might be other interventions to employ, such as ETC.

ECT (Electroconvulsive Therapy) is a shock treatment for depression and bipolar disorder. It is one of the safest and most effective treatment options. It involves sending an electric current through the brain to cause a controlled seizure. Experts believe that the train eases the symptoms of depression by altering the brain’s chemistry. 

Read More: Mental Health and Psychosocial Support in Emergencies

Get Trained to Treat Shock

Shock is a potentially life-threatening condition that occurs when the body is not getting adequate flow of blood. The lack of blood flow will deprive the organs and tissue of oxygen, causing the buildup of waste products. Without proper treatment and intervention, shock can result in severe tissue damage, organ failure, and even death. Shock treatment can be wide-ranging and specific to the type of cause and cause of the chick that has induced the condition. Apart from advanced medical management, the role of first aid training in treating casualties with shock is inevitable. The training will equip you with the knowledge and skills to stay upto to the best practices and improve your expertise in handling emergencies.