MANAGEMENT OF

SHOCK
DEFINITION:- It is generalized

inadequency of blood flow throughout the

body to the extent that the body tissue

are damaged because of too little flow,

especially too little delivery of oxygen and

other nutrients to tissue cell.

TYPES:-

SHOCK

HYPOVOLMIC CARDIOGENIC DISTRIBUTIVE

ANAPHYLACTIC SEPTICEMIC NEUROGENIC

ETIOLOGY:
1)HYPOVOLMIC:>
>HAEMORRHAGE
>TRAUMA
>BURNS
>DEHYDRATION

2)SEPTIC:>
>Gm +ve SEPTICEMIA
>Gm -ve SEPTICEMIA

3)CARDIOGENIC:>
>DEFICIENCY OF EMPTYING
>DEFICIENCY OF FILLING
>OUTFLOW OBSTRUCTION
 PATHOGENESIS
HYPOVOLUMIC & SEPTIC

DECREASED EFFECIENCY CIRCULATING VOLUME

DECREASED VENUS RETURN TO HEART

DECREASED CARDIAC OUTPUT

DECREASED BLOOD FLOW

DECREASED SUPPLY OF OXYGEN

ANOROXIA

SHOCK
CARDIOGENIC
CARDIAC OUTPUT

DECREASED BLOOD FLOW

DECREASED SUPPLY OF OXYGEN

ANOROXIA

SHOCK
CLINICAL FEATURES:-

>RAPID PULSE
>PULSE MAY BE WEAK
>RAPID BREATHING
>ANXIETY
>COOL,CALMMY SKIN
>WEAKNESS
>PALE SKIN COLOR(PALLOR)
>SWEATING,MOIST SKIN
>DECREASED OR NO URINE
OUTPUT
>LOW BLOOD PRESSURE
>CONFUSION
>UNCONCIOUSNESS
MANAGEMENT:
TREATMENT HYPOVOLMIC ENDOTOXIC CARDIOGENIC ANAPHYLATIC
>VOLUME YES YES USUALLY NO POSSIBLY
REPLACEMENT
>DOPAMINE YES YES YES POSSIBLY
>DOBUTAMINE POSSIBLY YES YES NO
>NONADRENALINE YES YES YES YES
>ADRENALINE NO NO NO DRUG OF
CHOICE
>VASODILATORS POSSIBLY NO POSSIBLY NO
>PHENYLEPINEP-
HRINE .... SOMETIMES .... SOMETIMES
>ISOPRENALINE NO NO NO NO
>GLUCOCORTI- IN ADDISON’S NO NO POSSIBLY
COIDS DISEASE
>ANTIHISTAMINICS NO NO NO YES