Shock

Shock is a dangerous condition when the blood pressure drops drastically so that the organs and tissues of the body do not get enough blood flow. This condition is usually a complication of another disease or condition.

Blood serves as a supplier of important substances for body tissue, such as nutrition and oxygen. In the condition of shock, there is a disturbance that causes the heart and blood vessels to not be able to flow blood to the body tissues optimally.

As a result, the supply of nutrients and oxygen needed for the body's tissues and organs to function normally becomes inhibited. This condition can occur simultaneously in all organs so that the effects can be fatal, especially if not treated immediately.

Causes of Shock

There are three factors that contribute to the occurrence of shock, namely:

• Inability of blood vessels to flow blood
• Inability of the heart to pump blood
• Lack of blood to flow

There are various diseases or conditions that can cause the things above and trigger the occurrence of shock. The following are the causes of shock based on its type:

• Cardiogenic shock
  Cardiogenic shock is caused by a disturbance in the heart, such as a heart attack or heart failure .
• Neurogenic
  shock Neurogenic shock is caused by a disturbance in the nervous system. This condition usually occurs due to spinal cord injury due to an accident while driving or doing activities.
• Anaphylactic
  shock Anaphylactic shock is caused by allergies due to insect bites, medicines, or food and drink.
• Sepsis
  shock Sepsis shock is caused by an infection that enters the bloodstream ( sepsis ) and triggers inflammation.
• Hypovolemic shock
  Hypovolemic shock is caused by the loss of fluid or blood in large amounts, for example due to diarrhea, bleeding in an accident, or vomiting blood .

Risk factors for shock

Shock can be experienced by anyone. However, there are several risk factors that can increase the occurrence of shock, namely:

• Cardiogenic shock is more likely to occur in the elderly (aged), patients with a history of heart attack, patients with coronary heart disease, as well as patients with diabetes or hypertension
• Neurogenic shock is more likely to occur in someone who has had a spinal cord injury or has taken drugs that affect the nervous system
• Anaphylactic shock is more prone to occur in someone who has experienced anaphylactic shock before, suffers from asthma or certain allergies, or has a history of anaphylactic shock in the family
• Sepsis shock is more common in people who have undergone surgery or been hospitalized for a long time, suffer from diabetes, have used catheters or breathing aids, or suffer from malnutrition
• Hypovolemic shock is more likely to occur in the elderly (aged) as well as patients with diseases that can cause bleeding

Symptoms of Shock

The supply of nutrients and oxygen that drops due to shock can result in several symptoms, such as:

• Shortness of breath
• Sweaty, cold, and pale skin
• The heart beats, and the pulse becomes weak
• Turn
• Drown
• Fainting until losing consciousness
• Bluish lips and fingernails (cyanosis)

In addition, based on the cause, each type of shock can cause the following additional symptoms:

• Cardiogenic shock, with symptoms of chest pain or heaviness, radiating pain in the shoulders and arms, nausea, and vomiting
• Neurogenic shock, with symptoms of body weakness, blank stare, and decreased body temperature ( hypothermia )
• Anaphylactic shock, with symptoms of swelling of the tongue or lips, difficulty swallowing, runny nose and sneezing, and tingling
• Sepsis shock , with symptoms of fever, chills, confusion, and anxiety
• Hypovolemic shock, with symptoms of diarrhea, vomiting, bleeding, anxiety, and confusion

When should you go to the doctor?

Call an ambulance immediately if people around you appear to be in shock. Shock is a condition that can worsen quickly so that it is very dangerous and can be life-threatening. Therefore, handling should be done as soon as possible to prevent complications, even death.

If you suffer from a disease that can cause shock, consult a doctor and do regular check-ups to prevent shock.

Diagnosis of Shock

Shock is an emergency that requires a quick diagnosis so that treatment can be done immediately. The doctor will look at the symptoms that appear, as well as check for clinical signs, such as a fast and weak heartbeat, rapid breathing, and low blood pressure.

Further, the doctor will immediately provide initial treatment to improve the patient's condition to become stable. After that, further examination will be done to detect the cause and type of shock suffered by the patient.

A series of checks that can be done are:

• Blood test
• Allergy test
• Scanning tests, such as USG, CT scan, or MRI
• Other tests are based on the cause of shock, such as electrocardiography for cardiogenic shock, or endoscopy for hypovolemic shock

Treatment of Shock

Shock is a dangerous condition. Immediately call a doctor or contact an ambulance service when you see someone who is suspected to be in shock. While waiting for help to arrive, give first aid to the patient.

The following is the first aid that can be done when seeing a patient who is suspected of suffering from shock:

• Lay the patient down slowly.
• Do not move or move the patient unless necessary.
• Loosen or loosen tight clothing.
• Check pulse and heart rate. If the victim is not breathing or there is no pulse, perform cardiopulmonary resuscitation ( CPR ).
• Give the sufferer a blanket, to warm and comfort him.
• Do not give the sufferer to drink or eat.
• Immediately give epinephrine in the form of an autoinjector if the shock is caused by an allergy and if the patient is found to be carrying this injection.
• Cover and stuff the bleeding area with a towel or cloth if the patient is bleeding.
• If the patient experiences vomiting or bleeding from the mouth, change the position to the side to avoid choking.

Once treated by medical personnel, the patient will receive emergency treatment until his condition is stable. Actions that can be taken include:

• Administering fluid infusion ( fluid resuscitation )
• Oxygen administration
• Opening of the airway
• Administration of drugs to restore blood pressure and regulate heart rate, such as norepinephrine

Further treatment will be done based on the type of shock and the cause of the shock, namely:

• Hypovolemic shock
  Hypovolemic shock caused by bleeding can be overcome with blood transfusion . However, if the bleeding cannot be controlled, the doctor can perform surgery to stop the bleeding when the patient's condition is stable.
• Cardiogenic shock
  Cardiogenic shock is treated by giving drugs that work to improve the heart's pump. These types of drugs are dopamine or dobutamine .
  Some surgical procedures can also be performed to overcome the cause of cardiogenic shock, such as angioplasty or bypass surgery , to overcome shock caused by a heart attack.
• Anaphylactic
  shock Anaphylactic shock is overcome by the administration of injectable epinephrine and antihistamines, which work to ease allergic reactions.
• Neurogenic
  shock Neurogenic shock is treated by protecting the nerve from further damage, sometimes with the help of anti-inflammatory drugs such as corticosteroids. If possible, the doctor will also perform an operation to repair damage to the nervous system.
• Sepsis shock
  To overcome the infection, the doctor can give antibiotics, antivirals, or antifungals, depending on the type of infection. Surgery can also be done to overcome the source of infection.

Complications of Shock

If not treated as soon as possible, shock can cause a lack of oxygen (hypoxia) throughout the body. This of course can damage tissue and body organs, leading to complications. Some of the complications that can appear as a result of shock include:

• Permanent organ damage, such as kidney, liver, or heart damage
• Damage to the brain
• Gangrene
• Heart attack
• Death

Prevention of Shock

Shock can be prevented by avoiding the disease that triggers it. Some things that can be done to prevent shock are:

• Perform routine heart examinations and regularly take medication for heart disease sufferers, to avoid cardiogenic shock
• Address signs of infection as soon as possible to avoid septic shock
• Apply safe driving behavior to avoid neurogenic shock due to spinal cord injury
• Be aware and avoid allergic triggers that have the potential to cause anaphylactic shock and always carry epinephrine in the form of an autoinjector (shaped like a pen)