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Shock is the state of insufficient blood flow to the tissues of the body as a result of problems with the circulatory system. Initial symptoms of shock may include weakness, tachycardia, hyperventilation, sweating, anxiety, and increased thirst. [1] This may be followed by confusion, unconsciousness, or cardiac arrest, as complications worsen. [1]
Other signs may be seen depending on the underlying cause. For example, jugular venous distension is a significant finding in evaluating shock. This occurs in cardiogenic and obstructive shock. This is not observed in the other two types of shock, hypovolemic and distributive. [3] Some particular clinical findings are described below.
Septic shock is a result of a systemic response to infection or multiple infectious causes. The precipitating infections that may lead to septic shock if severe enough include but are not limited to appendicitis, pneumonia, bacteremia, diverticulitis, pyelonephritis, meningitis, pancreatitis, necrotizing fasciitis, MRSA and mesenteric ischemia.
Neurogenic shock results from damage to the spinal cord above the level of the 6th thoracic vertebra. [5] It is found in about half of people who have a spinal cord injury within the first 24 hours, and usually persists for one to three weeks. [5] Neurogenic shock may be caused by severe brain injury. [6]
This causes a type of circulatory shock, called obstructive shock. Tension pneumothorax tends to occur in clinical situations such as ventilation, resuscitation, trauma, or in people with lung disease. [15] It is a medical emergency and may require immediate treatment without further investigations (see Treatment section). [15] [16]
The definition of refractory shock or vasodilatory shock varies. In 2018, the American College of Chest Physician stated that it is presents if there is an inadequate response to high-dose vasopressor therapy defined as ≥ 0.5 mg/kg/min norepinephrine-equivalent dose.
Shock is a clinical diagnosis, [4] meaning it is diagnosed based off of observations of a medical provider based on patient symptoms physical examination. Shock can be either compensated or decompensated. [2] Compensated shock means that the body is successfully working harder than normal to meet the body's needs for blood flow and perfusion of ...
The term "spinal shock" was introduced more than 150 years ago in an attempt to distinguish arterial hypotension due to a hemorrhagic source from arterial hypotension due to loss of sympathetic tone resulting from spinal cord injury. Whytt, however, may have discussed the same phenomenon a century earlier, although no descriptive term was assigned.