Shock state. Shock states of various origin what to do at any shock

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This is acutely developing and life-threatening condition that occurs as a result of severe injury, is characterized by a critical reduction in blood flow in tissues (hypoperfusion) and is accompanied by clinically pronounced violations of all organs and systems.

The leading in the pathogenesis of traumatic shock is pain (powerful pain impulse, which comes from the ground injury to the central nervous system). The neuroendocrine change complex with traumatic shock leads to the launch of all subsequent responses of the body.

Redistribution of blood. At the same time, the blood flow of the vessels of the skin, subcutaneous fatty fiber, muscles with the formation of sections in them and the accumulation of red blood cells in them. Due to the movement of large volumes of blood, relative hypovolemia is formed on the periphery.

Relative hypovolemia leads to a decrease in the venous return of blood to the right-wing heart departments, a decrease in cardiac output, decrease in blood pressure. The decrease in blood pressure leads to a compensatory increase in overall peripheral resistance, disruption of microcirculation. The disorder of microcirculation, its progression is accompanied by hypoxia organs and tissues, and the development of acidosis.

Traumatic shock is often combined with internal or outer bleeding. What naturally leads to an absolute decrease in the volume of circulating blood. Despite the exceptional importance in the pathogenesis of the traumatic shock of blood loss, nevertheless should not identify traumatic and hemorrhagic shocks. With severe mechanical damage to the pathological effects of blood loss, the negative effect of neur-pain impulse, endotoxicosis and other factors is inevitable, which makes the status of traumatic shock is always heavier compared to the "clean" blood loss in an equivalent volume.

One of the main pathogenetic factors forming traumatic shock is toxmia. Its effect begins for 15-20 minutes from the moment of injury. Endothelium and, first of all, renal has been exposed to toxic. In this connection, polyorgan failure is quickly formed.

The diagnosis of traumatic shock occurs on the basis of clinical data: the values \u200b\u200bof the blood pressure of the systolic and diastolic, pulse, colors and humidity of the skin, the size of the diurea. In the absence of arrhythmia, the degree and severity of hemodynamic disorders can be estimated using a shock index (Algéra).

With closed fractures, blood loss is:
. Ankles - 300 ml;
. shoulder and shin - up to 500 ml;
. hips - up to 2 l;
. Bones pelvis - up to 3 l.

Depending on the size of systolic blood pressure, 4 degrees of gravity of traumatic shock are isolated:
1. I degree - systolic pressure decreases to 90 mm Hg. Art.;
2. II degree of gravity - up to 70 mm Hg. Art.;
3. III severity - up to 50 mm Hg;
4. IV severity - less than 50 mm RT. Art.

Clinic

With a shock, clinical manifestations may be scarce. The overall state of moderate. Hell is slightly reduced or normal. Easy inhibition. Pale, cold skin. Positive symptom of "White Spot". CSS increases to 100 in 1 minute. Student breathing. Due to the increase in the content of catecholamines in the blood, there are signs of peripheral vasoconstrictions (pale, sometimes "goose" skin, muscular trembling, cold limbs). Signs of blood circulation disorders appear: Low CVD, reduction of cardiac output, tachycardia.

With III degree of traumatic shock, the condition of patients is severe, consciousness is preserved, stiffness is observed. The skin is pale, with an earthly tint (appears when a sampling with hypoxia), cold, is often covered with cold, sticky sweat. Hell is consistently reduced to 70 mm Hg. Art. And less, the pulse is rapid up to 100-120 per 1 min, weak filling. There is a shortness of breath, worried about thirst. Diuresis is sharply reduced (oliguria). IV The degree of traumatic shock is characterized by the extremely heavy state of the patients: pronounced adamine, indifference, leather and mucous membranes are cold, pale gray, with an eartling tint and marble pattern. Pointed features. Hell lowered to 50 mm Hg. Art. and less. The CLOD is close to zero or negative. Pulse threaded, more than 120 in 1 minute. Anuria or Oliguria are marked. At the same time, the condition of microcirculation is characterized by parires of peripheral vessels, as well as internal combustion system. Clinically, it is manifested by improving the bleeding of fabrics.

In the clinical picture of traumatic shock, the specific features of individual types of injuries are reflected. So, with severe injuries and injuries, breasts are observed psychomotor arousal, the fear of death, hypertonus of skeletal muscles; A short-term rise of hell is replaced by his rapid drop. In the cranial injury, a pronounced tendency towards arterial hypertension, masking a clinical picture of hypoxyerculation and traumatic shock be traced. With intra-abdominal damage for traumatic shock, symptoms of developing

Urgent Care

Treatment of traumatic shock should be complex, pathogenetically substantiated, individual in accordance with the nature and localization of damage.

Provide the maintenance of the upper respiratory tract using the triple reception of the Safara, the auxiliary ventilation of the lungs.
. Inhalation of 100% oxygen for 15-20 minutes, followed by a decrease in oxygen concentration in the inhaled mixture to 50-60%.
. In the presence of intense pneumothorax - drainage of the pleural cavity.
. Stop bleeding by finger pressed, tight dressings, imposition of harness, etc.
. Transport immobilization (must be performed as early as possible and more reliable).
. Anesthesia by using all types of local and conductor anesthesia. Under the fractures of large bones, local anesthetics are used in the form of a blockade directly zone of fracture, nerve trunks, bone-fascial cases.
. Parenteral (intravenous) introduced the following angletical cocktails: Atropine sulfate 0.1% solution 0.5 ml, Sibaz 0.5% solution 1-2 ml, Tramadol 5% solution 1-2 ml (but not more than 5 ml) or promotionalol 2 % solution 1 ml.
. Or atropine sulfate 0.1% solution 0.5 ml, sybazone 0.5% solution 1 ml, ketamine 1-2 ml (or at a dose of 0.5-1 mg / kg body weight), tramadol 5% solution 1-2 ml (but no more than 5 ml) or promidal 2% solution of 1 ml.

It is possible to use other analgesics in equivalent doses.

The most important task in the treatment of traumatic shock is the most rapid restoration of blood supply to fabrics. With an indefinable level, the hell requires inkjet transfuses into two veins (under pressure) so that in 10-15 minutes it is to achieve lifting systolic pressure to a level of at least 70 mm RT. Art. The infusion rate should be 200500 ml in 1 minute. Due to the significant expansion of the vascular space, it is necessary to introduce large volumes of fluid, sometimes 3-4 times superior to the intended blood loss. The rate of infusion is determined by the dynamics of blood pressure. The inkjet infusion must be carried out until the hell will not steal up to 100 mm Hg. Art.

Table 8.5. The program of infusion therapy during the transportation of the victim

Glucocorticosteroids are introduced intravenously in the initial dose of 120-150 mg of prednisolone and subsequent at a dose of at least 10 mg / kg. The dose can be increased to 25-30 mg / kg body weight. Treatment of heart failure may require the inclusion of Dobutamine's therapy at a dose of 5-7.5 μg / kg / min or dopamine 5-10 MG / kg / min, as well as drugs that improve myocardial metabolism, antihypoxants - riboxin - 10-20 ml; cytochrome C - 10 mg, Actovegin 10-20 ml. In the development of the terminal state or inability to ensure emergency infusion therapy, dopamine in 400 ml of 5% solution of glucose or any other solution at a speed of 8-10 drops in 1 minute is intravenously introduced. With internal bleeding, conservative events should not delay the evacuation of victims, since only an emergency operation can save their lives.

The sequence of activities may vary depending on the predominance of certain violations. The victim is transported to the hospital against the background of continuing intensive therapy.

Sacrut V.N., Kazakov V.N.

Sho k and eg o p r o me in l e n i

The term "shock" means in translation .

This is a critical, between life and death, the condition of the body, characterized by deep disorders and oppression of all life functions (respiration, blood circulation, metabolism, liver, kidney, etc.). A shock state may occur with heavy injuries, extensive burns and large blood loss. The development and deepening of the shock contribute to pain, body cooling, hunger, thirst, the shaking transportation of the victim.

Shock is the active protection of the body from the aggression of the environment.

Depending on the cause that causes the development of a shock state, distinguish:

1. Shock due to exposure to external reasons: - traumatic,arising from mechanical injury (wounds, bone fractures, squeezing fabrics, etc.);

- burning associated with burn injury (thermal and chemical burns);

- cold , developing when exposed to low temperature;

- electric which is a consequence of electrician.

2. Shock caused by the impact of internal reasons:

- hemorrhagic arising from acute and massive blood loss;

- to ardiogenic , developing with myocardial infarction;

- from eppicious, being a consequence of a total purulent infection in the body.

When a person faces a threat to death, his body is in a state of stress allocates a huge amount of adrenaline.

REMEMBER! Adrenaline's enjoyment emission causes a sharp spasm of preacapillars of the skin, kidneys, liver and intestines.

The vascular network of these and many other organs will be almost excluded from blood circulation. And such vital centers like a brain, heart and partly lungs will get blood much more than usual. There is a centralization of blood circulation of the hope that after overcoming the extreme situation, they will again be able to proceed to normal livelihoods.

Remember! Only due to the spasm of the vessels of the skin and its exceptions from blood circulation compensates for the loss of 1.5 - 2 liters of blood.

That is why in the first minutes of shock, thanks to the spasm of the prokapillary and a sharp increase peripheral resistance(PS)The body can not only maintain blood pressure in the limits of normal, but also exceed it even with intensive bleeding.

The first signs of the development of shock:

Sharp pale of skin;

Emotional and motor arousal;

Inadequate assessment of the situation and its condition;

No complaints on pain even with shock damage.

The ability to forget about pain at the time of mortal danger is explained by the fact that morphine-like substance is produced in subcortical structures of the brain - endomorphinol( Inner, own morphine). Its similar drug action causes a condition of easy euphoria and anesthetics even with heavy injuries.

On the other hand, the pain activates the functions endocrine glandsand above all the adrenal glands.It is they who distinguish the amount of adrenaline, the action of which will cause the spasm of breaspillars, an increase in blood pressure and the increase in heartbeat.

The bark of adrenal glands allocates and corticosteroids (their analog synthetic - prednisolone), which significantly accelerates metabolism in tissues.

This allows the body to throw out the entire supply of energy in extremely short time and concentrate the effort to get away from danger.

Two phases of shock distinguish:

- short-term erotic(excitation period) Phase occurs immediately after injury and is characterized by motor and speech excitations, as well as complaints of pain. In full preservation of consciousness, the victim underestimates the severity of his condition. Pain sensitivity is raised, the voice is deaf, the words are rubbed, the eyes are restless, the face is pale, blood pressure is normal or elevated. The excited state is rapidly (within a few minutes), it gradually gradually, goes into an oppressed, accompanied by a decrease in all life functions.

- thorpid phase (The period of oppression: lat. Torpidum - braking) is characterized by general weakness and a sharp drop in blood pressure. Breathing becomes frequent and superficial. The pulse is frequent, uneven, threaded (barely hard). The face is pale, with a hortal shade, covered with cold sticky sweat. The victim slowed down, it does not respond to questions, it is indifferent to others, pupils are expanded, the consciousness is saved. In severe cases, vomiting and involuntary urination are possible.

This phase, as a rule, ends with death and is considered irreversible..

If during 30-40 minutes the victim does not receive medical care, the long-term centralization of blood circulation will lead to gross disorders of microcirculation in the kidneys, skin, intestines and other organs excluded from blood circulation. Thus, the fact that he played a protective role at the initial stage and gave a chance to salvation, the cause of death after 30 -40 minutes.

A sharp decline in blood flow rate in capillaries, up to a complete stop, will cause a disorder of oxygen transport and accumulation in the tissues of unsophisticated exchange products - acidosis, the lack of oxygen - the gypoxia of death in the living organism of individual organs and tissues - necrosis.

This stage is very quickly replaced by agony and fatal outcome. .

A complex of anti-shock events.

It is necessary to free the injured factor affected;

Ensure a stop of bleeding;

To stabilize the breath, provide the influx of fresh air and give a position providing breathing;

Give painkillers (analgin, barallgyin, pentalgin);

To give funds, tonic activity of the cardiovascular system (Corvalol - 10-15 drops, Cordiamine, Lily of the Lilyside);

The victim should be warm;

Give abundant warm drinking (tea, coffee, water with the addition of salt and food soda - 1 teaspoon of salt and 0.5 teaspoon of soda per 1 liter of water);

Immobilization of injured body parts;

In the case of stopping cardiac activity and respiration, urgent resuscitation measures should be taken (IVL, outer heart massage);

The victim cannot be left alone!

Shock is a pathological change in the functions of the life systems of the body, in which disruption of respiration and blood circulation is noted. This condition was first described yet by Hippocratic, however, the medical term appeared only in the mid-18th century. Since various diseases can lead to the development of shock, for a long time scientists offered a large number of theories of its occurrence. In this case, none of them explained all the mechanisms. Currently, it has been established that the shock is based on arterial hypotension, which occurs with a decrease in the volume of circulating blood, reducing cardiac output and the total peripheral resistance of the vessels or during the redistribution of fluid in the body.

Shock manifestations

The symptoms of shock are largely determined by the reason that led to its appearance, however, there are general features of this pathological condition:

• violation of consciousness that can manifest itself with excitation or oppression;
• reduction of blood pressure from insignificant to critical;
• an increase in heart rate, which is a manifestation of a compensatory reaction;
• the centralization of blood circulation, in which the spasm of peripheral vessels is happening with the exception of kidney, brain and coronary;
• pallor, marble and cyanosis of the skin;
• student superficial respiration arising from the increasing of metabolic acidosis;
• changing the body temperature, usually reduced, but in the infectious process is increased;
• pupils, as a rule, are expanded, the reaction to the light is slowed;
• in particular difficult situations, generalized convulsions, involuntary urination and defecation develop.

There are also specific manifestations of shock. For example, when exposed to allergen, bronchospasm develops and the patient begins to choke, with blood loss, the person is experiencing a pronounced feeling of thirst, and with myocardial infarction - chest pain.

Degree of shock

Depending on the severity of the shock, four degrees of its manifestations are distinguished:

1. Compensated. In this case, the patient's condition is relatively satisfactory, the system of systems is saved. It is in consciousness, systolic blood pressure is reduced, but exceeds 90 mm Hg, the pulse is about 100 per minute.
2. Subcompensated. There is a violation of vital activity. The patient's reactions are injected, it is sluggish. Skin pale, wet. Cardiac frequency reaches 140-150 per minute, superficial breathing. The condition requires a speedy medical intervention.
3. Decompensated. The level of consciousness is reduced, the patient is strongly inhibited and reacts poorly to the external stimuli, does not respond to questions or in one word. In addition to pall, the skin marble is observed due to a microcirculation disorder, as well as cyanosis of fingertips and lips. The pulse can only be determined on the central vessels (sleepy, femoral artery), it exceeds 150 per minute. Systolic blood pressure often below 60 mm Hg. There is a violation of the work of the internal organs (kidneys, intestines).
4. Terminal (irreversible). The patient is usually unconscious, the breathing is superficial, the pulse is not forgiven. The usual method with a tonometer pressure is often not determined, the tones of the heart are deaf. But the skin appears blue stains in places of cluster of venous blood, similar to the body. Reflexes, including pain, absent, the eyes are still, the pupil is expanded. The forecast is extremely unfavorable.

To determine the severity of the state, you can use the Alfreor's shock index, which is obtained by dividing the heart rate on systolic blood pressure. Normally, it is 0.5, at 1 degree -1, with the second -1.5.

Types of Shock

Depending on the immediate reason, several types of shock are distinguished:

1. Traumatic shock arising from external influence. In this case, there is a violation of the integrity of some tissues and the occurrence of pain syndrome.
2. The hypovolemic (hemorrhagic) shock develops with a decrease in the volume of circulating blood due to bleeding.
3. Cardiogenic shock is an complication of various diseases of the heart (, tamponade, an aneurysm break), in which the left ventricle emission fraction is sharply reduced, as a result of which arterial hypotension is developing.
4. The infectious-toxic (septic) shock is characterized by a pronounced decrease in the peripheral resistance of the vessels and an increase in the permeability of their wall. As a result, the redistribution of the liquid blood is taken, which accumulates in the interstitial space.
5. Develops as an allergic response in response to intravenous effects of a substance (injection, insect bite). At the same time, it will be released into the blood of histamine and the expansion of vessels, which is accompanied by a decrease in pressure.

There are other varieties of shock, which include various signs. For example, a burning shock develops due to injury and hypovolemia due to large losses of fluid through the wound surface.

Help with shock

The first help with shock should be able to provide every person, as in most situations the bill goes for moments:

1. Most importantly, what needs to be done, try to eliminate the cause that caused a pathological condition. For example, when bleeding, you need to lose arteries above the location of damage. And when the insect bite, try not to give to spread the poison.
2. In all cases, with the exception of cardiogenic shock, it is desirable to raise the legs of the head of the head. This will help improve the blood supply of the brain.
3. In cases of extensive injuries and suspicion of the spine, it is not recommended to move the patient until the ambulance arrives.
4. To fill the loss of fluid, it is possible to give a patient to drink, preferably warm, water, as it is faster in the stomach.
5. If a person has pronounced pain, he can take an analgesic, but it is not desirable to use sedatives, since the clinical picture of the disease should change.

Ambulance doctors in cases of shock are used or solutions for intravenous injections, or vasoconstrictors (dopamine, adrenaline). The choice depends on the specific situation and is determined by the combination of various factors. Medical and surgical treatment of shock directly depends on its type. Thus, during hemorrhagic shock, it is necessary to urgently fill the volume of circulating blood, and with anaphylactic introduction antihistamines and vasoconstricting drugs. The victim needs to be accidentally delivered to a specialized hospital, where treatment will be carried out under the control of vitality.

The forecast for shock depends on its type and degree, as well as the timeliness of assistance. With light manifestations and adequate therapy, recovery is almost always coming, whereas with a decompensated shock, the likelihood of death, despite the efforts of doctors.

The pain shock is manifested by the reaction to pain, as a result of which the nervous, cardiovascular and respiratory system suffer primarily.

It proceeds gradually and has different stages.

If you do not undertake immediate action, this situation is fraught with a dangerous outcome up to death.

It is important to have time to provide the first help before the arrival of the doctor's brigade.

The pain shock is a rapidly developing and threatening the body's response to excessive pain exposure, accompanied by serious violations of all systems and organs.

The main sign, in addition to acute pain, is a decrease in pressure.

The reasons

The main cause of shock is the injury of blood flow caused by painful stimulus, which can be:

• cold;
• burn;
• mechanical impact;
• lesion current;
• fractures;
• knife or bullet injuries;
• complications of diseases (jams of food lump in the esophagus, uterus break, ectopic pregnancy, colic in the liver and kidneys, heart attack, sulfur stomach ulcer, stroke).

The injury disrupts the integrity of the vessels and is accompanied by loss of blood. As a consequence, the volume of the circulating fluid decreases, the organs are not powered by blood, lose the ability to perform functions and die away.

In order for the proper level to maintain blood supply to vital organs (the brain, heart, light, liver, kidneys) compensatory mechanisms come into business: the blood decreases from other organs (intestines, leather) and comes to it. Those. The distribution (centralization) of blood flow occurs.

But this is enough for a while for a while.

The next compensatory mechanism is tachycardia - improving the strength and frequency of heart rate. This increases the blood stream through the organs.

Since the body works for wear, after a period of time, the compensation mechanisms become pathological. The tone of the microcirculatory line (capillaries, vesul, arteriole) decreases, blood is stood in the veins. From this the body is experiencing another shock, because The total area of \u200b\u200bWesull is huge and blood for the organs does not circulate. The brain comes the signal about repeated blood loss.

The second is losing muscle tone capillaries. Blood deposited in them, why the thrombus and obstruction arise there. The process of blood turning is disturbed, because plasma flows out of it, and another portion of shaped elements flows into the same place. Due to the fact that the tone of the capillaries is not restored, this phase of shock is irreversible and finite, cardiac insufficiency occurs.

Due to bad blood supply in other organs, their secondary failure appears.

The CNS cannot carry out complex reflex acts, violations in its work are progressing as ischemia (dieting tissue) of the brain.

Changes affect the respiratory system: hypoxia occurs, breathing is expensive and is done superficial or, on the contrary, hyperventilation occurs. This negatively reflects on the abnormal functions of lungs: combating toxins, cleaning the incoming air from impurities, depreciation of the heart, voice, blood deposition. In Alveoli, blood circulation suffers, which leads to an edema.

Because The kidneys are very sensitive to the lack of oxygen, the development of urine is reduced, then renal failure in acute form is observed.

Such is the mechanism of the stress reaction to the gradual involvement of all organs.

Damage to the spinal cord as a result of injury leads to a spinal shock. This condition is dangerous for life and health, so it is important correctly and in time to provide first aid. According to the link detail about the tactics of treatment.

Symptoms, signs and phases

The first phase of pain shock - excitation, second - braking. For each of them are characterized by their symptoms.

At the initial stage (erectile) patient is excited, he appears euphoria, the increase in pulse, respiratory movements, finger tremors, high pressure, pupils are expanding, it does not realize his condition. A person can shout out the sounds, make rude movements. Stage lasts up to 15 minutes.

The first phase of pain shock is replaced by trapid. The main feature is a decrease in pressure, as well as:

• lethargy, apathy, inhibition, indifference to what is happening (although there may be an excitement and anxiety);
• pallitude of the skin;
• not traceable, frequent, threaded pulse;
• decrease in body temperature;
• the coldness of the hands and legs;
• loss of sensitivity;
• superficial breathing;
• syneva lips and nails;
• large droplets of sweat;
• reduced muscle tone.

It is the second phase that manifests itself in acute heart failure and stress reaction in the form of insufficient of all other organ systems to such an extent that it is impossible to maintain vital activity.

In this phase, the following sections of shock are distinguished:

• I degree - Disorders in the flow of blood according to vessels are not expressed, blood pressure and pulse normally.
• II. The degree - pressure while reducing the heart muscle drops to 90-100 mm Hg. Art., there is an inhibition, a rapid pulse, the skin becomes white, the peripheral veins fall down.
• III The degree is the condition of the patient heavier, the blood pressure drops to 60-80 mm Hg, the pulse is weak, 120 beats per minute, the skin is pale, the chopping sweat appears.
• IV The degree - the state of the victim is regarded as very heavy, his thoughts confused, the consciousness, skin and nails are becoming blue, marble (spotted) drawing appears. Arterial pressure - 60 mm Hg. Art., Pulse - 140-160 beats per minute, it can only be forgiven on large vessels.

The calculation of blood loss is the most convenient to produce the magnitude of the "upper" blood pressure.

Table. The dependence of blood loss from systolic pressure

Upon reduced pressure and crank and brain injury, analgesics cannot be applied!

First aid with pain shocked

Initially, the patient must be warm up using heating, blankets, warm clothes, then dug hot tea. With a pain of a shock, the victim is forbidden to drink. If there is vomiting and wounds of abdominal cavity drinking liquid is prohibited!

A cold subject is applied to the place of damage, for example, ice. Delete foreign objects from the body of the patient before the doctors arrive are not allowed!

If the pain shock is caused by the injury, it is necessary to stop the bleeding of harness, dressings, clips, tampons, gullible gauze bandages.

With the loss of blood, the damaged vessel is clarified by the harness, with wounds, fractures and impaired integrity of soft tissues impose a tire. It should go beyond the joints above and below the damaged area of \u200b\u200bthe bone, and between it and the body must be laid a gasket.

You can transport the patient only after removing the symptoms of the shock.

Korvalol, Valokordin and Analgin will help to stop the attack of pain.

Treatment

For each stage, their healing measures have been developed, but there are general rules for the treatment of shock.

• We need to help as early as possible (shock lasts about a day).
• The therapy is long-term, complex and depends on the cause and severity of the state.

Medical events include:

• bringing to the desired level of circulating fluid volume (replenishment of blood loss through intravenous infusion of solutions);
• normalization of the inner environment of the body;
• pain relief pain relief;
• elimination of respiratory failures;
• preventive and rehabilitation measures.

With a shock of I-II degree to block pain, the plasma or 400-800 ml of polyglyukine is introduced to block pain. This is important when moving the patient for a large distance and preventing the exacerbation of the shock.

During the patient's movement, the receipt of drugs stop.

With a shock of II-III degree after the administration of polyglyukin is transfused with 500 ml of saline or a 5% glucose solution, later polyglyukine is prescribed with the addition of 60-120 ml of prednisone or 125-250 ml of adrenal hormones.

In severe cases of infusion, produced in both veins.

In addition to injections at a fracture site, local anesthesia is carried out with a local anesthesia 0.25-0.5% novocaine solution.

If the internal organs are not affected by the affectedness for anesthesia, 1-2 ml of 2% of Promedol, 1-2 ml of 2% canopone or 1-2 ml of 1% morphine, and also run tramadol, ketanes, or a mixture of analgin with dimedrol in the ratio 2 :one.

During the Schocy III-IV degree, the anesthesia is produced only after the purpose of polyglyukine or regularlyukin, analogues of adrenal hormones are introduced: 90-180 ml of prednisone, 6-8 ml of dexamethasone, 250 ml of hydrocortisone.

The patient is discharged by drugs that increase the pressure.

It is impossible to achieve a quick raising hell. Imagine protein substances that increase blood pressure (Meston, dopamine, norepinephrine), is strictly prohibited!

With any species of shock, the inhalation of oxygen is shown.

Even some time after the shock state, the pathology of the internal organs is possible due to the violation of the blood supply. This is expressed in poor coordination of movements, inflammation of peripheral nerves. Without the adoption of antish-flock measures, death comes from painful shock, so it is important to be able to provide prefigure help.

Video on the topic

Shock is a certain state in which there is a sharp shortage of blood to the most important human organs: heart, brain, light and kidney. Thus, the situation in which the existing blood volume is not enough to fill the existing volume of vessels under pressure. To some extent, shock is a state preceding death.

The reasons

The causes of the occurrence of the shock are caused by a violation of the circulation of a fixed volume of blood in a certain volume of vessels that are able to narrow and expand. Thus, among the most common causes of shock, a sharp decrease in blood volume (blood loss) can be distinguished, the rapid increase in vessels (the vessels are expanding, as a rule, responding to acute pain, allergen falling or hypoxia), as well as the inability of the heart to perform functions assigned to it ( Heart injury when falling, myocardial infarction, "inflexibility" of the heart with a tense pneumothorax).

That is, shock is the inability of the body to ensure normal blood circulation.

Among the main manifestations of the shock, a rapid pulse is highlighted above 90 shots per minute, a weak threaded pulse, reduced blood pressure (up to its complete absence), a rapid breathing, in which a person is at rest breathing as if it acts as a heavy physical activity. The skin's pallor (the skin acquires a pale blue or pale yellow shade), no urine, as well as a sharp weakness in which a person cannot move and pronounce words, are also signs of shock. The development of shock can lead to the loss of consciousness and the absence of a response to pain.

Types of Shock

Anaphylactic shock is a shock form for which a sharp extension of vessels is characteristic. The reason for the occurrence of anaphylactic shock can be a certain reaction to the allergen person in the human body. It may be a bee bite or the introduction of the drug, which is allergic.

The development of anaphylactic shock occurs on the fact of the allergen hit to the human body, regardless of what quantities he fell into the body. For example, it doesn't matter how much the bees bitten a person, since the development of anaphylactic shock will occur anyway. Nevertheless, the place of bite is important, since with the defeat of the neck, language or field of the person, the development of anaphylactic shock will occur much faster than when the bite in the leg.

Traumatic shock is a shape of a shock for which it is characterized by the extremely severe condition of the body, provoked by bleeding or painful irritation.

Among the most common causes of the development of traumatic shock can be distinguished by pale of the skin, the release of sticky sweat, indifference, inhibition, as well as a rapid pulse. Among the remaining reasons for the development of traumatic shock, you can distinguish thirst, dry mouth, weakness, anxiety, unconscious state or confusion. These signs of traumatic shock to some extent are similar to the symptoms of internal or outer bleeding.

Hemorrhagic shock shape of a shock at which the urgent state of the body is observed, developing due to the acute loss of blood.

The degree of blood loss has a direct impact on the manifestation of hemorrhagic shock. In other words, the power of manifestation of hemorrhagic shock directly depends on the amount that the volume of circulating blood (CSC) decreases for a rather short period of time. The loss of blood in a volume of 0.5 liters, which occurs during the week, will not be able to provoke the development of hemorrhagic shock. In this case, the anemia clinic is developing.

Hemorrhagic shock arises as a result of bloodstures in a total volume of 500 and more ml, which is 10-15% of the volume of circulating blood. Loss of 3.5 liters of blood (70% of the BCC) is considered deadly.

Cardiogenic shock is a shock form for which a complex of pathological conditions in the body, provoked by a decrease in the contractile function of the heart.

Among the main signs of cardiogenic shock, it is possible to distinguish interruptions in the work of the heart, which are a consequence of heart rate disorders. In addition, with cardiogenic shock, interruptions in the work of the heart are noted, as well as pain in the chest. For myocardial infarction, a strong sense of fear with pulmonary artery thromboembolism, shortness of breath and acute pain.

Among other signs of cardiogenic shock, vascular and vegetative reactions can be distinguished, which develop as a result of decrease in blood pressure. Cold sweat, pale, replacing the imagination of nails and lips, as well as sharp weakness is also symptoms of cardiogenic shock. Often marked the emergence of a sense of strong fear. Due to the swelling of the veins, which occurs after the heart ceases to pump blood, swelling the neck of the neck. With thromboembolism, cyanosis comes fairly quickly, and the marble of the head, neck and chest is noted.

With a cardiogenic shock after stopping breathing and cardiac activity, loss of consciousness may occur.

First aid for shock

Provided medical care during serious injury and injury can prevent the development of a shock state. The effectiveness of first aid with shock depends largely on how quickly it is provided. The first aid with a shock is to eliminate the main reasons for the development of this state (stopping bleeding, reducing or removing pain, improved breathing and cardiac activity, general cooling).

Thus, first of all, in the process of providing first aid, a shock should be eliminated by the reasons that caused this state. It is necessary to free the victim from under the wreckage, stop the bleeding, repay the burning clothes, neutralize the damaged part of the body, eliminate the allergen or provide temporary immobilization.

In the event that the victim is conscious, it is recommended to offer him an anesthetic and, if possible, drink hot tea.

In the process of providing first aid, the shock must be loosen the gestures on the chest, neck or belt.

The victim must be put in such a pose so that the head is turned on the side. Such a pose avoids the spares of the tongue, as well as suffocation with the lots of the masses.

If shock came in the cold time, the victim should be warm, and if it is roast - to protect against overheating.

Also in the process of providing first aid with shock, if necessary, the mouth and the nose of victims from foreign objects should be released, after which they have a closed heart massage and artificial respiration.

The patient should not drink, smoke, use heating and hot water bottles, and remain alone.

Attention!

This article is placed exclusively in cognitive purposes and is not a scientific material or professional medical council.

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