Shock In The Medical Sense

Definition

Shock in the medical sense is an emergency situation. With this information, you can recognize a shock and provide useful first aid. Colloquially, a shock scares us – or we are paralyzed, shocked for a short time. For medical professionals, however, shock is a serious life-threatening clinical picture. Read more about the causes, symptoms, and first aid here.

What is a Shock?

A shock in the medical sense is a condition in which the oxygen supply to the organs is no longer ensured due to a lack of blood in the bloodstream. This deficiency can have very different causes. The most common are internal and external bleeding (mostly due to injuries) as well as disorders of the fluid balance, which continue to reduce the blood volume. Long-term diarrhea, massive vomiting, or profuse sweating can also cause shock. Doctors refer to these causes as a volume deficiency shock.

If enough blood is no longer pumped into the body in the event of heart failure, those affected also fall into a state of shock. Medics say they get shocked. The technical term for this form of shock is cardiogenic shock.

Symptoms

In order to supply the body with vital oxygen, the heart rate rises to more than 100 beats per minute at the beginning of the shock. Typically, the blood pressure drops sharply (first value below 90 mmHg).

Shock states can also be recognized externally: The skin is pale and usually feels cool and moist. People in shock are often very thirsty. The longer a shock lasts, the shallower the breathing becomes. The blood pressure continues to drop, the pulse is racing and can hardly be felt. Eventually, those affected lose consciousness.

Shock In The Medical Sense

Depending on the cause of the shock, there are other symptoms:

    • in anaphylactic shock: allergic symptoms such as rashes, itching, facial swelling, and shortness of breath
    • in cardiogenic shock: chest tightness and difficulty breathing
    • with septic shock: fever or reduced body temperature below 36 degrees Celsius and bleeding in the skin, the skin is sometimes red and overheated.

Causes

Allergy sufferers know anaphylactic shock as the most severe allergic reaction. Many allergy sufferers carry an emergency kit with them in order to be able to take action against the life-threatening allergy-related shock condition.

In the case of blood poisoning (sepsis), septic shock can develop in the end-stage. This almost always leads to death.

In addition, there are even rarer forms of shock such as neurogenic shock (nerve-related), electric shock (as a result of an electrical accident), endocrine shock (hormone-related), hypoglycemic shock (insulin shock), and orthostatic shock (due to a disturbed vascular and circulatory regulation).

Examination

Recognize shock with the Rekap sample

Rescue workers often use their fingernails to test for shock. But every layperson can do that too. The so-called Rekap-Probe consists of briefly pressing the fingernail into the nail bed. The blood under the nail is squeezed out of the smallest blood vessels, the capillaries, and the skin turns white. If you let go of your fingernail, you pay attention to the time it takes for the skin under the nail to turn red again. If this so-called recapillarization (recap) lasts longer than a second, it can be seen as an indication of poor blood circulation. Of course, this is not a reliable diagnostic criterion, but it is still a guide.

Treatment

First aid: ensure shock positioning and call an emergency doctor

If a shock is suspected, the emergency services should be alerted immediately. Until the emergency vehicle arrives, first aid with so-called shock positioning is possible. The legs are positioned higher than the head, for example, the patient lies on their back and the legs are placed on a chair/stool. This is intended to increase the return of the blood to the heart and improve the supply of organs.

No shock position for B injuries

However, there are a number of shock states in which the shock positioning is not useful and even harms. Many rescue workers remember these cases with a donkey bridge. It reads: “B = shock position nee”. These include the following 6 Bs:

    • Pear: visible and invisible head and skull injuries, fluid leakage from nose and/or ears
    • Chest: pain in the heart and chest area
    • Abdomen: Injuries or pain in the abdomen
    • Legs: open broken legs with protruding bones or any suspicion of a broken leg
    • Pelvis: Injuries in the pelvic area
    • Hump: Injuries to the back and spine, especially with numbness or paralysis of the limbs or uncontrolled urination and stool.

Don’t panic about first aid

Most people very rarely get into situations where they have to respond to shock. Most often this happens in traffic and work accidents. No matter how severe the accident is: First get an overview, then secure the accident area and then alert the emergency services. After that, you can give first aid. This is the best way to help yourself and others to survive a state of shock in good health.