Shock - it is the response of the body to the action of external aggressive stimuli, which may be accompanied by impaired blood circulation, metabolism, the nervous system, breathing and other vital functions.
There are some causes of shock:
1. Injuries due to mechanical or chemical attack: burns, fractures, breach tissue, tearing limbs, the impact of the current (traumatic shock);
2. Related injury loss of blood in large amounts (hemorrhagic shock);
3. incompatible blood transfusion to the patient in a large amount;
4. Contact allergens in sensitized Wednesday (anaphylactic shock);
5. extensive necrosis of the liver, intestine, kidney, heart; ischemia.
Diagnose shock a person who has had a shock or trauma, it can be based on the following criteria:
- blurred consciousness with tachycardia;
- lowering blood pressure;
- impaired breathing
- decreased urine output;
- skin cold and wet, marble or pale - cyanotic color
The clinical picture of shock
The clinical picture of shock varies depending on the severity of the impact of external stimuli. For proper assessment of the person who underwent the shock and assist in shock, we must distinguish several stages of this condition:
1. Shock 1 degree. The man retained consciousness, he comes in contact, although slightly inhibited the reaction. Indicators pulse - 90-100 beats, systolic blood pressure - 90mm;
2. Shock 2 degrees. The reactions in humans also inhibited, but he is conscious, correct answers to questions, talking in a low voice. There is rapid shallow breathing, rapid pulse (140 beats per minute), the blood pressure is reduced to 90-80 mm Hg The prognosis for such a shock serious condition that requires immediate antishock of procedures;
3. Shock 3 degrees. The man inhibited the reaction, it does not feel pain and adinamichen. He speaks patient slowly and whispered, questions may not respond at all, or monosyllables. Consciousness may be missing completely. The skin is pale, with a pronounced acrocyanosis, covered in sweat. Pulse of the victim delicate, detectable only on the femoral and carotid arteries (usually 130-180 u. / Min). Also, there is shallow and rapid breathing. Central venous pressure may be lower than zero or zero, and systolic blood pressure - below 70 mm Hg
4. Shock 4 degrees - a terminal condition of the body, expressed often irreversible pathological changes - tissue hypoxia, acidosis, intoxication. The patient's condition in this form of shock is extremely serious and the prognosis is almost always negative. The victim is not listening heart, he was unconscious and breathing surface with sobs and convulsions. No reaction to pain, dilated pupils. In this blood pressure - 50 mm Hg, and can not be detected at all. Pulse is also barely noticeable, and felt only on the main arteries. Human skin - gray, with distinctive marbled pattern and spots like corpse, indicating a general decline in blood supply.
Types of shock
The shock is classified depending on the cause of shock. So, you can select:
- Vascular shock (septic, neurogenic, anaphylactic shock);
- Hypovolemic (angidremichesky and hemorrhagic shock);
- Cardiogenic shock;
- Painful shock (burn, traumatic shock).
Vascular shock - a shock caused by a decrease in vascular tone. Its subspecies: septic, neurogenic, anaphylactic shock - a state with a different pathogenesis. Septic shock is caused by bacterial infection of human infection (sepsis, peritonitis, gangrene). Neurogenic shock is most often seen after an injury or spinal medulla. Anaphylaxis - a flowing severe allergic reaction that occurs within the first 2-25 minutes. after exposure of allergen to the body. Substances that can cause anaphylactic shock are drugs plasma and plasma proteins roentgenopaque anesthetics and other drugs.
Hypovolemic shock caused by an acute shortage of circulating blood, secondary emission reduction of the heart, decreased venous return to the heart. There is a state of shock with dehydration, loss of plasma (angidremichesky shock) and blood loss - hemorrhagic shock.
Cardiogenic shock - an extremely difficult condition of the heart and blood vessels, characterized by a high mortality rate (50 to 90%), and occurs as a result of serious circulatory disorders. In cardiogenic shock the brain due to lack of blood flow (heart irregularities, enlarged blood vessels, unable to keep the blood), is experiencing a sharp shortage of oxygen. Therefore, a person in a state of cardiogenic shock, loses consciousness and often die.
Painful shock, as cardiogenic, anaphylactic shock - a common shock that occurs when acute reactions to personal injury (traumatic shock) or burn. And it is important to understand that burn and traumatic shock - a kind of hypovolemic shock, because their cause is the loss of large amounts of plasma or blood (hemorrhagic shock). It can be internal and external bleeding and plasma exudation of fluid through the burned skin on burns.
Help in shock
Assisting in shock, it is important to realize that often the cause of belated shock states is improper transport the injured and providing first aid for shock, so carrying elementary rescue procedures before the arrival of the ambulance is very important.
Help in shock, is in the following events:
1. Eliminate the cause of shock, for example, to stop the bleeding, to release jammed limbs on the affected extinguish burning clothing;
2. Check for foreign objects in the mouth and nose of the victim, if necessary, remove them;
3. Check for breathing, heart rate, and, if necessary, carry out heart massage, artificial respiration;
4. Make sure that the victim is lying with his head to the side so he would not choke on his own vomit, he did not zapadet language;
5. Determine whether the patient is conscious, and give him an anesthetic. It is desirable to provide the patient with hot tea, but before that exclude abdominal injury;
6. Loosen clothing at the waist, chest, neck of the victim;
7. The patient is necessary, depending on the season, warm or cool;
8. The victim should not be left alone, he can not smoke. You also can not be applied to the injured sites warmer - it could trigger an outflow of blood from vital organs.