What is Shock?Shock is a medical emergency characterised by a systemic lack of adequate blood flow resulting to not enough oxygen reaching the body’s organs and tissues, leading to a life-threatening condition. Various factors can cause it and as a consequence, the body’s vital organs suffer from inadequate perfusion, resulting in a cascade of physiological responses. Prompt recognition of the signs of shock and immediate intervention is essential to stabilise the individual and prevent further complications.
Types of ShockThis condition manifests in various forms, each with its own underlying causes and unique characteristics. Here are some of the primary types of shock:
Hypovolemic ShockOccurs when there is a significant loss of blood or fluids from the body. This can result from traumatic injuries, decreased blood volume from severe bleeding, internal haemorrhage, or dehydration. Individuals experiencing hypovolemic shock may exhibit symptoms such as:
- rapid heartbeat
- cool and clammy skin
- low blood pressure
Cardiogenic ShockStems from a malfunctioning heart that fails to pump blood effectively. Causes can include heart attacks, heart failure, or severe arrhythmias. Individuals in cardiogenic shock may display symptoms such as:
- chest pain
- rapid and weak pulse
- pale skin
- shortness of breath
Distributive ShockOccurs due to widespread dilation of blood vessels, causing blood to pool in peripheral tissues and reducing overall blood flow. This type of shock can result from severe infections (septic shock), severe allergic reactions (anaphylactic shock), or neurological damage (neurogenic shock). Signs and symptoms can include:
- rapid and weak pulse
- warm and flushed skin
- decreased blood pressure
- altered mental status
What is Neurogenic Shock?It is a type of distributive shock that occurs as a result of damage or disruption to the nervous system, specifically the spinal cord. It can be caused by traumatic spinal cord injuries, severe brain injuries, or certain medical conditions affecting the nervous system. Neurogenic shock is characterised by the sudden loss of sympathetic nervous system function, leading to widespread blood vessel dilation and a subsequent decrease in blood pressure.
Obstructive ShockArises when there is a physical obstruction that impedes blood flow, preventing the heart from effectively pumping blood. Causes include conditions like pulmonary embolism, cardiac tamponade, or tension pneumothorax. Individuals experiencing obstructive shock may exhibit symptoms such as:
- rapid breathing
- chest pain
- weak pulse
Causes of ShockBy familiarising ourselves with the diverse triggers, we can better comprehend the underlying factors that contribute to this critical medical condition. Here are some common causes of shock: Haemorrhage: Loss of blood from internal or external bleeding, whether due to traumatic injuries, accidents, or surgical complications, can lead to hypovolemic shock.
Fluid Loss: Loss of plasma or fluids from conditions like severe burns, excessive vomiting, or dehydration can result in hypovolemic shock.
Allergic Reactions: Anaphylactic shock can arise from severe allergic reactions to substances such as food, medication, insect stings, or latex.
Infections: Severe infections, particularly those leading to sepsis, can trigger distributive shock known as septic shock.
Cardiac Issues: Heart problems, including heart attacks, heart failure, or severe arrhythmias, may result in cardiogenic shock.
Toxic Exposure: Poisoning from chemicals, gases, alcohol, or drugs can cause toxic shock, affecting multiple organ systems.
Animal Bites: Envenomation from snake or animal bites can lead to systemic shock, especially if the venom contains toxins that affect circulation.
Respiratory Issues: Severe respiratory problems or chest trauma can impede oxygenation and contribute to the development of shock.
Lack of Oxygen: Conditions such as severe asthma attacks, carbon monoxide poisoning, or suffocation can deprive the body of oxygen, leading to shock.
Obstructions: Blockages in the airway, such as choking on a foreign object, can obstruct breathing and potentially result in shock.
Injuries: Shock can occur in response to various types of injuries, ranging from minor to severe, depending on factors such as the extent of trauma and the individual’s overall health.
Recognising the Signs and SymptomsWhile symptoms of shock may have slight variations in their manifestations, the overarching goal remains the same—to recognise the onset of shock and take immediate action, including calling emergency services when necessary.
Early-stage symptoms may include:
- Rapid pulse
- Pale, greyish-blue skin
- Slower capillary test
- Sweating and cold clammy skin
- Cold sensation
- Weakness and giddiness
- Nausea and vomiting
- Rapid shallow breathing
- Weak thready pulse
- Restlessness, anxiety, and aggressiveness
- Difficulty breathing, yawning and gasping for Air
First Aid for ShockWhen faced with a casualty in shock, immediate first aid intervention is crucial for stabilising their condition. Here are optimised steps to follow in providing first aid for shock:
- If the casualty is unconscious but breathing, place them in the recovery position to help maintain an open airway.
- If the casualty is conscious, lay them down flat on their back to improve blood flow to vital organs.
- Promptly control any bleeding by applying direct pressure to the wound. Address and treat any other injuries present.
- Dial emergency services (e.g. triple zero) to request professional medical care. Provide accurate information about the situation.
- Make the casualty comfortable by loosening tight clothing to reduce constriction.
- Keep the casualty warm by covering them with a blanket or using additional layers of clothing. This helps prevent further heat loss.
- Provide reassurance and keep the casualty calm to minimise anxiety and stress.
- Continuously monitor the casualty’s physical condition, including their breathing, pulse, and level of responsiveness.
- You may moisten the casualty’s lips if they are dry, but avoid allowing them to eat or drink anything.
- If the casualty becomes unresponsive and is not breathing normally, follow the DRSABCD protocol, which stands for Danger, Response, Send for help, Airway, Breathing, Circulation, and Defibrillation, if needed. Begin CPR (cardiopulmonary resuscitation) as appropriate.
CPR First Aid Australia’s Available CoursesCPR First Aid Australia is offering a variety of first aid courses according to your needs. You can choose your preferred courses below:
- HLTAID009 Provide cardiopulmonary resuscitation
- HLTAID010 Provide an emergency first aid response
- HLTAID011 Provide first aid – formerly known as Level 2 or Senior First Aid.
- HLTAID012 Provide first aid in an education and care setting
- HLTAID014 Provide advanced first aid
- 22578VIC Course in First Aid Management of Anaphylaxis
- 22556VIC Course in the Management of Asthma Risks and Emergencies in the Workplace
Do You Need General First Aid Qualification?We recommend the HLTAID011 Provide first aid.
- This also includes CPR qualification. The Australian Resuscitation Council (ARC) recommends that this qualification is updated every 3 years.
Do You Need To Update CPR Qualification?We recommend HLTAID009 Provide cardiopulmonary resuscitation.
- The Australian Resuscitation Council (ARC) recommends that this qualification is updated annually.