Last Updated On: diciembre 5, 2024
Have you heard the phrase “going into shock” in a medical setting? Shock refers to a sudden drop in blood flow in your body, which carries serious health risks. During an episode, your organs may not receive adequate blood, potentially leading to permanent organ damage. Distributive shock is a type of shock that affects around 80-90% of the population. Whether caused by severe allergic reactions or asthma attacks, proper diagnosis and prompt treatment offer the best odds of survival.
Read on to learn more about the types of distributive shock and how to respond during such emergencies.
Distributive shock, also known as vasodilatory shock, refers to systemic vasodilation and decreased blood flow to vital organs, including the brain, heart, and kidneys. This condition causes fluid to leak from the capillaries into the surrounding tissues. Distributive shock eventually leads to multiorgan failure due to an imbalance between oxygen supply and demand.
Because of its complexities, managing distributive shock requires a multimodal approach. The phases involved in the condition include:
If distributive shock is caused by systemic vasodilation, the first phase will be the “warm” phase. It causes the formation of arteriovenous shunts, making the cardiac output affect the capillaries and causing ischemia of tissues. Since there is peripheral vasodilation, it will make the skin feel warm. Ischemia will eventually influence endothelial damage and loss of fluids, thereby decreasing plasma volume.
The decreased plasma volume and low blood pressure stimulate vasoconstrictors, including catecholamines, angiotensin, and vasopressin. Vasoconstriction causes the skin to become cool, leading to cold shock.
Read More: A Guide to Understand Shock: Causes, Types, and Symptoms?
In general, distributive shock is caused by various factors, including allergic reactions, burns, or infections, which lead to a significant decrease in blood pressure. To opt for the right treatment, whether it’s medications, intravenous fluids, or mechanical ventilation, you need to know the underlying cause and the types of shock. Here’s a brief overview of each type of distributive shock:
Anaphylactic shock, or anaphylaxis, is a severe allergic reaction that is potentially life-threatening. It occurs within minutes of exposure to an allergen and can be fatal without proper treatment. The symptoms of the condition appear within 15 minutes.
Anaphylaxis, or anaphylactic shock, is characterized by a wide range of symptoms that vary depending on the allergens that induce the condition. Some common shock symptoms are:
Individuals can take steps to avoid experiencing anaphylactic shock if they know the causative factors behind the infection. Let us explore some of the common causes of anaphylaxis.
Food allergies from peanuts, walnuts, pecans, shellfish, eggs, milk, or any seafood can trigger anaphylactic reactions. A food allergy test or a blood test will help accurately diagnose the allergies and prevent the occurrence of the condition.
Allergies from insect venom or stings can also induce anaphylactic shock, including bee stings, wasps, yellow jackets, hornets, fire ants, and more. Ensure that you take preventive measures to avoid exposure to insects as much as possible.
Latex found in medical equipment and supplies such as disposable gloves, syringes, adhesive tapes, and intravenous tubes, can also cause anaphylaxis. Be aware of latex’s presence in your day-to-day life to avoid contact with the substance.
Anaphylaxis can also result from the intake of certain medications, including antibiotics, nonsteroidal anti-inflammatory drugs, and anesthesia. Consult your healthcare professional to avoid these triggering drugs and opt for safe alternatives.
In some cases, anaphylaxis may resolve on its own without treatment. However, in severe cases, delaying a prompt response can lead to fatal outcomes. Here are some effective treatment options for anaphylactic shock:
If you have a history of severe allergic reactions, ensure that you carry an epinephrine auto-injector to quickly treat the symptoms and prevent life-threatening respiratory or cardiovascular complications. However, even after administration, visit the nearest emergency center to prevent the recurrence of symptoms.
Administering antihistamines can treat itching, hives, and swelling caused by anaphylaxis. Corticosteroids reduce inflammation and prevent further damage to the body, effectively lessening the severity of the allergic reaction. These medications help to control the condition and prevent it from worsening.
In severe cases of anaphylactic shock, breathing treatments might be necessary. Performing CPR or using a nebulizer or inhaler can open up the airways and provide relief from symptoms.
Neurogenic shock occurs when blood vessels stop functioning properly and fail to push adequate blood through the body. This causes blood to pool in the vessels, leading to a significant drop in blood pressure. The condition is often the result of a severe injury or damage to the brain. When left untreated, it can cause permanent organ damage, failure, or even death.
A stroke or blood clot causing neurogenic shock often prevents proper blood circulation, leading to its symptoms. Common symptoms include:
Neurogenic shock causes blood pressure to drop due to improper circulation and loss of muscle activity in the blood vessels. Insufficient oxygenated blood puts you at risk of organ damage.
When experiencing neurogenic shock, your heart rate will slow down compared to the normal rate. During episodes of bradycardia, the heart rate decreases to under 60 beats per minute, worsening the lack of blood flow in the body.
During neurogenic shock, blood pools in the veins instead of circulating properly, causing the skin to appear flushed. Due to the reduced blood volume under the skin, the skin will feel warm and dry to the touch.
The primary cause of neurogenic shock is spinal cord injury, especially when the injury affects the region above the T6 vertebra. Such injuries can disrupt the sympathetic outflow from the thoracolumbar region of the spinal cord. Other causes of the condition include:
Traumatic injuries, such as dislocations, fractures, or penetrating wounds to the spine, can severely damage the spinal cord, resulting in neurogenic shock. Severe head trauma can lead to increased intracranial pressure, which may subsequently affect the brainstem and disrupt autonomic pathways.
The administration of spinal anesthesia may occasionally result in neurogenic shock, especially if the anesthetic spreads beyond the intended area, affecting the sympathetic nervous system.
Tumors or infections that affect the spinal cord can also induce neurogenic shock by disrupting autonomic pathways.
Read More: How to Prevent Infections from Spreading?
The shock treatment for neurogenic conditions involves a proactive management approach to stabilize the patient and address the underlying cause. Treatment strategies include:
Emergency care for shock involves fluid resuscitation, which helps restore blood pressure and improves tissue perfusion. Isotonic crystalloids are typically administered through an intravenous route.
If fluid resuscitation is insufficient to maintain adequate blood pressure, vasopressors such as norepinephrine or phenylephrine will be administered to induce vasoconstriction and elevate blood pressure. In severe cases, atropine may be used to prevent excessive parasympathetic activity and improve heart rate.
If the victim has a spinal cord injury, immobilization and stabilization of the spine will prevent further damage. In certain cases, surgical intervention may be recommended to decompress the spinal cord and stabilize the vertebrae.
Septic shock or sepsis, a type of distributive shock, happens at the advanced stage of infection. When you get an infection, your immune system will try to fight it off. However, in some cases, the immune system will cause damage to the body, due to overwhelming reaction. When it occurs, your blood pressure will drop to dangerously low levels and the organs will begin to fail.
Despite the high mortality rate, early diagnosis of the system will help you seek the right treatment and raise the chances of survival. Common signs and symptoms include,
Prompt medical intervention will increase the chances of speedy recovery in victims with septic shock. However, to seek the appropriate treatment, you should know the underlying cause of the condition. Some common causes of sepsis include,
Septic shock happens due to severe infection, either due to bacteria, fungus, or virus. Common sources of such infection include pneumonia, urinary tract infections, abdominal infections, skin infections, and bloodstream infections.
When your body’s immune response to the infection becomes dysregulated, it will trigger widespread inflammation, resulting in septic shock. Moreover, any chronic illnesses or invasive medical procedures can also increase the risk of developing septic shock, by compromising your body’s ability to fight infection effectively.
Shock treatment of sepsis typically involves timely interventions to address the underlying infection that will stabilise blood pressure and support organ function. The key components of treatment include,
Prompt administration of broad-spectrum antibiotics will target the suspected or identified pathogens to control the infection.
Administration of Intravenous fluids restores blood volume and improves tissue perfusion, using balanced crystalloid solutions or colloids in the initial stage of treatment.
To maintain organ function, patients may require supplemental oxygen, mechanical ventilation, or renal replacement therapy. In severe cases, surgical drainage or debridement may be recommended to remove the source of infection, such as infected tissues or abscesses.
Distributive shock is a medical emergency requiring immediate response to improve the chances of survival. In severe cases, the victim needs close monitoring and comprehensive medical care to stabilize heart function and restore normal breathing. While recovery might take a long time, ensure you follow a proper lifestyle, rest, and rebuild your strength. Proper CPR training can make a difference in being prepared for such life-altering incidents. Take preventive measures to protect yourself and your loved ones.
