A shock is a critical condition in which organ perfusion decreases sharply, that is, all, especially vital organs, are in a state of oxygen starvation.
Among the causes of this condition, the main ones are: traumatic injury, burns, loss of blood, infection, a sharp weakening of the heart muscle function, the ingress of an allergen into the human body, which was previously sensitized.
Types of shock
Depending on the reasons as a result of which this condition develops, several types can be distinguished:
1. hypovolemic shock;
2. traumatic or painful;
3. burn;
4. anaphylactic;
5. infectious toxic;
6. cardiogenic;
7. turnstile.
Hypovolemic shock
This type of critical condition develops most often. For this reason, it is worthwhile to dwell on its description in more detail. Hypovolemic shock develops as a result of an acute shortage of circulating blood volume. As a result, venous flow to the heart decreases and a secondary decrease in cardiac output occurs.
The immediate causes of this type of emergency are blood loss (both external and internal); fluid loss in infectious diseases. A decrease in blood volume can also occur as a result of accumulation of fluid in the abdominal cavity with peritonitis, traumatic damage to soft tissues.
Hypovolemic shock in infectious diseases develops in connection with a dehydration syndrome, more often with intestinal infections, namely food toxicoinfection, salmonellosis, cholera, and so on. However, this does not always happen. If treatment of intestinal infection is started in a timely manner, then such a critical condition will not develop.
For a better understanding of what hypovolemic shock is, it is necessary to consider the pathogenesis of its development. In its development, three phases can be distinguished:
1. lack of circulating blood volume;
2. activation of the sympathetic-adrenal system;
3. directly shock.
At the first stage, the human body experiences a deficiency in the volume of fluid in the bloodstream, which is manifested by a decrease in venous flow to the heart, and a decrease in central pressure. As a result of these processes, cardiac output is reduced. During the first hour, interstitial fluid rushes into the capillaries, which means that the volume of the intercellular sector decreases.
At the second stage, baroreceptors are stimulated reflexively, which spurs the sympathetic-adrenal system. As a result of this, the secretion of catecholamines increases: norepinephrine increases tenfold, adrenaline - hundreds.
At the same time, there is a decrease in the sympathetic tone of the veins, heart and arterioles, which entails an increase in the ability of the myocardium to reduce and increase the heart rate. And then there is a centralization of blood circulation. In the third stage, which begins in the absence of treatment, as a result of prolonged hypovolemia, a steady decrease in perfusion develops.
Clinically, hypovolemic shock is manifested by a frequent small pulse; low systolic blood pressure; decreased central venous pressure; cold, moist, pale cyanotic, even marbled skin; slow blood flow in the nail bed; oliguria.
If the slightest signs of hypovolemic shock develop, you should immediately contact a medical institution for help. Do not think that such a condition can stop on its own. In order to save a person, it is best to call an ambulance team, which even at the stage of transportation will begin to provide first aid. In this state, even the slightest delay can cost a person life.