Shock

Definition

Shock occurs when inadequate blood flow threatens the function of multiple organs. Shock is a potentially life-threatening condition. The sooner it is treated, the better the outcome. If you suspect someone is in shock, dial 911 immediately.

Causes

Some causes of shock include:

Congestive heart failure
Heart attack
Spinal cord injury
Sepsis (infection of the blood)
Other severe infection
Allergic reaction
Poisoning
Loss of blood volume (hypovolemia)—This can be from severe bleeding or severe dehydration.
Heatstroke
Trauma

Risk Factors

The following factors increase your chances of developing shock:

Pre-existing heart disease
Impaired immunity
Severe allergies

Symptoms

If you experience any of these, do not assume it is because of shock. These symptoms may be caused by other, less serious health conditions. If you experience any one of them, see your doctor. The symptoms of shock depend on the cause.

Symptoms may include:

Weakness
Altered mental status
Cool and clammy skin
Low blood pressure
Decreased urination
Weak and rapid pulse
Slow and shallow or rapid and deep breathing
Lackluster (dull) eyes
Dilated pupils

Symptom of Shock

Diagnosis

When you arrive at the hospital, your doctor will perform a physical exam.

Tests may include the following:

Breathing assessment
Blood pressure measurement
Heart rate monitoring
Other tests, depending on the cause of shock

Treatment

Talk with your doctor about the best plan for you. Treatment options include the following:

Breathing Resuscitation

If you are having trouble breathing, your doctor will clear your airway. Oxygen and breathing assistance may be provided if you need it.

Optimizing Blood Pressure and Heart Rate

You may receive an IV and/or blood transfusions. These will stabilize your blood pressure and heart rate.

Insertion of IV for Transfusion or Medications

Medications

You may be given vasopressor medications. These constrict your blood vessels to increase blood pressure. Drugs may also be used to increase your heart contractions.

Prevention

To help reduce your chances of getting shock, take the following steps:

Prevent or control heart disease.
Avoid activities that put you at risk of falls or other injuries.
Carry an epinephrine pen with you if you have a severe allergy.

RESOURCES

American College of Emergency Physicians http://www.acep.org/

National Institutes of Health http://www.nih.gov/

CANADIAN RESOURCES

Canadian Association of Emergency Physicians http://caep.ca/

Canadian Red Cross http://www.redcross.ca/

References

Goldman L, Ausiello D, eds. Cecil Textbook of Internal Medicine. 23rd ed. Philadelphia: Saunders; 2008.

Kumar A, Patel S. Focus on: shock and pressors. American College of Emergency Physicians website. Available at: http://www.acep.org/webportal/membercenter/periodicals/an/2006/oct/shockpressors.htm . Accessed October 26, 2006.

Marx JA, et al. Rosen's Emergency Medicine.7th ed. St. Louis, MO: Mosby, Inc.; 2009.

Shock: first aid. Mayo Clinic website. Available at: http://www.mayoclinic.com/health/first-aid-shock/FA00056 . Accessed October 26, 2006.

The signs of hypovolemic shock. Health Guidance website. Available at: http://www.healthguidance.org/entry/12784/1/The-Signs-of-Hypovolemic-Shock.html . Accessed April 11, 2011.

Revision Information

Reviewer: Peter Lucas, MD
Review Date: 10/2012
Update Date: 10/11/2012

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.