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Last Updated: Jun 12, 2020
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Shock: Signs, Causes, Types and Treatment

About Stages Types Symptoms Treatment Side effects Post-treatment guidelines Recovery Cost Results Alternatives

What is shock?

When the organs and the tissues of the body are not receiving proper flow of blood, then such a medical condition is known as shock. Shock deprives the flow of oxygen into various organs of the body and induces piling up of waste materials. Shock, when becomes very serious, can also cause death.

What are the 3 stages of shock?

There are three stages of shock are:

  • Stage I: In the first stage of shock, the blood flow becomes low. This situation is called perfusion. As a result, the heart starts beating faster, blood vessels throughout the body becomes smaller in diameter, and the kidney starts retaining fluid into the circulatory system. All these accumulate to increase blood flow into the significant organs and organ systems of the body.
  • Stage II: In the second stage of shock, the systems in the body cannot continue perfusion further, and other complications are noticed. Deprivation of oxygen into the brain and heart leads to disorientation of the patient and chest pain respectively.
  • Stage III: In the third stage of this disorder, the prolonged time of perfusion further deteriorates the patient’s conditions. The heart and the kidney almost stop functioning, cells and other organs also start malfunctioning. Finally, the person dies if proper treatment is not given on time.

What are the 4 types of shock?

There are Four types of shocks are:

  • Cardiogenic shock: In case of cardiogenic shock, inflammation of the heart muscles, heart attack, disturbances of the normal rhythmic heartbeat, fluid accumulation or clot in the heart are the common causes.
  • Hypovolemic shock: When a person suffers from hypovolemic shock, reasons behind it may be excess fluid loss, dehydration, excess urination, extensive burns, blockage in the intestine and inflammation of the pancreas. All these reasons lead to lesser volume of blood in the body.
  • Distributive shock:When your blood vessels lose their tone due to some conditions, it can cause distributive shock. The blood vessels become floppy and open that is not enough to supply blood pressure to your organs. There are a number of types of distributive shock which includes the following:
    • Septic shock: It can occur when any bacterial infection is allowed to stay in the body for a very long time without treatment. Bacteria produce toxins that spread throughout the body and damage the circulatory system.
    • Anaphylactic shock: This type of shock is a complication of a severe allergic reaction known as anaphylaxis. Allergic reactions occur when your body mistakenly treats a harmless substance as harmful which triggers a dangerous immune response. This type of shock is usually caused by allergic reactions to food, insect venom, medications, or latex.
    • Neurogenic shock: It is caused by damage to the central nervous system, usually a spinal cord injury. This causes blood vessels to dilate and skin feel warm and flushed. The heart rate slows, and the blood pressure drops very low.
  • Obstructive shock: Obstructive shock is a type of shock which occurs when blood can not get where it needs to go. A pulmonary embolism is one condition that may cause an interruption to blood flow. Conditions that can cause a buildup of air or fluid in the chest cavity can also lead to obstructive shock.

What are the signs and symptoms of shock?

Symptoms of shock include:

  • Cold hands and feet
  • Blue-tinged or pale skin
  • Weak pulse rate
  • Low blood pressure
  • Drowsiness
  • Fainting
  • Blue or gray lips or fingernails
  • Irritability
  • Anxiety
  • Dizziness
  • Enlarged pupils
  • Nausea or vomiting

What is the treatment for shock?

Shock is a situation where the human body is unable to receive optimum amount of blood in the body. Therefore to treat such a disorder, the proper amount of blood flow should be assured to all the important internal organs as well as in blood vessels and tissues. Treatment of circulatory shock can be done by securing the airway through intubation if required, so as to decrease the breathing and guarding against respiratory arrest.

Administration of intravenous fluids into the patient’s body is strongly recommended. It means that a certain quantity of saline water is to be given to the person suffering from this disorder. If the patient remains in shock even after the very first treatment mentioned above, then packed red blood cells should be given in order to keep the haemoglobin more than 100 g/L. Artificial oxygen provision is also suggested for treatment of shock.

Certain medicines can be used to treat shock. Vasopressors are used to increase blood pressure along with the body fluids. Dopamine and norepinephrine are the most commonly used vasopressors to treat shock. Activated protein C is also used to manage circulatory shock that occurs due to bacterial infection. Sodium bicarbonate is also used to treat shock, but the pH of NaHCO3 has to be less than 7, otherwise it would not show proper outcomes. Certain antibiotics are also used to treat shock.

Certain mechanical supports are provided to the patients to treat circulatory shock. Intra-aortic balloon pumps (IBAP) are used to increase myocardial oxygen perfusion as well as cardiac output at the same time. Once the cardiac output is increased, the coronary blood flow increases, thereby increasing the myocardial oxygen. A ventricular assisting device (VAP) helps in cardiac circulation by assisting one of the ventricles or both of the together to induce an optimum blood flow mechanism in the body.

An artificial heart can be used to support the damaged human heart if necessary. If the normal heart of the patient is malfunctioning too much and cannot pump blood properly, an artificial one can be installed after removing the original heart. If the heart is unable to pump optimum amount of blood and is using the exact amount of oxygen that is required to maintain a healthy body, an Extracorporeal Membrane Oxygenation System (ECMO) can be installed to let the heart perform its task in a normal way.

Are there any side effects?

Vasopressin used can be sometimes harmful for the patient who is suffering from shock. There is a risk of having arrhythmia due to consumption of vasopressin. The usage of various electronic devices in trying to cure this disorder can lead to other problems.

The use of IBAP can lead to ischemia, occlusion of renal artery leading to kidney failure, cerebral embolism, infection and other problems. The use of VAD also has various side effects. It can lead to infections, heart failure, viral transmission and blood clotting leading to stroke. The usage of ECMO also has side effects like neurological injuries, heparin induced thrombocytopenia, intra-ventricular haemorrhage in children is quite common.

What are the post-treatment guidelines?

The post-treatment guidelines for the treatment of the problem of shock are to see that the patient is having a proper blood circulation in the body. For that, the patient is to be taken for regular check-ups to the doctor. Checking the blood pressure should be done regularly, and the pressure should not be allowed to fall.

Urine tests and blood tests should be done regularly to keep a check on the body fluids; which cannot be allowed to become acidic in nature. If electronic devices are installed within the body of the patient, those should be also under regular check, as external devices to cure a person can also create problems within the body.

How long does it take to recover?

The shock occurring in body is a disorder that can be treated if the blood pressure and blood supply is kept optimum. This job is done by inducing a few external things into the body. But it is to be noted that there is no permanent recovery from the problem of shock.

The patient has to be kept under supervision throughout his/her life, especially if an external electronic device, say an artificial heart is installed within their body, then the patient may be released from the hospital within 5 to 10 days after the device has been installed, but needs to stay under constant supervision.

What is the price of the treatment in India?

The treatment of shock that involves fluid intake and medicines are not costly at all. However, the cost of device installation to treat shock can vary between Rs. 3,90,000 to Rs.7,80,000 in India. This treatment is available in the leading hospitals of various metropolitan cities in India.

Are the results of the treatment permanent?

The treatment of problems of shock using mere medicines and fluids provides temporary relief. However, once the devices are installed in a person, he/she has to use it throughout life. With the aid of them, the affected person can survive properly and lead a normal life.

What are the alternatives to the treatment?

Certain careful measures can be taken by the affected person at home. The affected person’s airway, breathing and circulation can be checked every 2 minutes. The person should not be allowed to eat or drink anything when the shock occurs.

The person should be allowed to wear loose fitting clothes. Also, the best way to give an alternative treatment is to prevent shock from occurring. Whenever a person is suffering from immense dehydration due to diarrhoea or dysentery, he/she should be made to drink a lot of water. Food that produces blood should be taken regularly.

Popular Questions & Answers

Current condition of pappa age: 53 weight: 60 height: 168 cm my dad had 1 block of 95% so we did ptca-om on 10/10/2018. From that day to till now he is not normal and did not able to go to work. Currently our cardiologist prescribed 3 tablets: 1) rosurica gold 10 mg- contains: aspirin (75 mg) + rosuvastatin (10 mg) + clopidogrel (75 mg) 2) escigress cz 0.25 - contains: escitalopram (10 mg) + clonazepam (0.25 mg) 3) rabolin dsr: contains: domperidone (30) + rabeprazole (20 mg) he always says that he feels 1. Some times different sensations like vibration in blood vessels and minutes shocks in heart. 2. Continuous tingling in palms and more in fingers. 3. Numbness, or a decrease in the ability to feel or sense pressure or texture in hands. 4. Heart burn. 5. Feeling of burns in different parts of body like in back on left side of chest. 6. Always feel to lay on bed. 7. Second-degree hemorrhoids without blood from last 20 years 8. Hyperglycaemia sometimes (sugar level on border) 9. He feels that the stent became loose or pain at the site of stent in heart. 10. Always feels tired and weakness. 11. Hyper acidity with a lot of burps. 12. Digestion problem (sometimes indigestion and constipation). 13. Feeling of fluttering in vessels or muscles (now became rarer). 14. Feeling of piercing in back and on the site of stent in heart (now became rarer). 15. Sometimes pain in shoulder, upper back, chest. 16. Frequent pain or burning sensation in chest and upper back. Due to lighten our financial condition is worst, that's why he always takes tension, stress, depression, and burden. He thinks a lot even on a small thing and takes tension of that, his thinking capacity is too high. Irritability on small things. He always thought negatively, never thinks positive. He always blame us that why we did angioplasty, because he never became normal like how he was before angioplasty. He lost his 10 kg weight. He feels that his body is completely damaged from inside. When he hears something bad anything about health of somebody then he thinks alot and applies that's on himself and feels like that person's health condition on himself. He is vaccinated with 1st dose of covisheild vaccine on 12/04/2021.

MD - Psychiatry, MBBS
Psychiatrist, Vadodara
Your father's symptoms suggest that he might have post cardiac disease depression and anxiety. With proper medications and counseling sessions, he can definitely find improvement.

Having paresthesia. Taking maxgalin 75 feeling drowsiness. Us there any other treatment for that. Age 34 consulted neuro physician. Having numbness and tingling in both hand, specially in left hand.

MD Medicine, DM Neurology
Neurologist,
Maxgallin has been given for paraesthesia actually withou coming to a reasonable diagnosis, what is the cause of your symptoms. If more details about paraesthesia are furnished like exact location, aggravating and relieving factors and any loss of...
1 person found this helpful

Hi there. Thanks for accepting my question. My heart rate is 44 beats per minute and my oxygen saturation is 97% while I was falling asleep. I am a 23 year old female with normal blood pressure and normal bmi. The past week, I haven’t been receiving enough sleep. But my heart rate has never been this low before. I do mild exercise daily. I’m afraid to fall asleep because of my low heart rate. Each time i’m falling asleep, I notice my heart rate drop to 44 and the I jerk myself awake and it goes back up to 50. I don’t have any other symptoms apart from fatigue (it’s 3 am here so this could be the reason why) and tingling of hands which i’m not sure if it’s caused by anxiety.

BASM, MD, MS (Counseling & Psychotherapy), MSc - Psychology, Certificate in Clinical psychology of children and Young People, Certificate in Psychological First Aid, Certificate in Positive Psychology, Positive Psychiatry and Mental Health
Psychologist, Palakkad
Dear user. I can understand. Please don't be panic but be serious about the symptoms. Consult your physician for physical investigation. Please provide more information so that we can start the diagnosis process and the treatment. I am here to hel...

I am not taking milk o symptoms like numb and tingling sensation and I have severe b12 deficiency now. I m.taking me 12 0d tablet twice a day as well calcirol sachet once in a week. Do I need injection?

MD Medicine, DM Neurology
Neurologist,
If you take 5 doses of vit b 12, that may have better compliance and rapid effect, calcirol is for vit d, but the best strategy is rely less on the additive vitamins rather than improving your diet and eating well balanced diet and doing exercises...
1 person found this helpful

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