Shock, also known as traumatic shock, is one of the most dangerous and most frequent complications that can occur as a result of a severe trauma, which causes a marked depression of the body's functions in general.
An unstable nervous system, general weakness, insufficient nutrition, advanced age, fear, grief, worries, etc. predispose to shock. Hemorrhage also predisposes, which is one of the main causes of shock.
Accidents or serious traumas are often followed immediately or later by traumatic shock.
If it occurs immediately, it is called primary shock, and if it occurs some time later, it is called secondary shock.
WHAT ARE THE SYMPTOMS OF SHOCK?
The most common symptoms of shock include:
- When the state of shock begins, the victim is markedly weak, with a tendency to faint and dizzy. Sometimes he or she is very thirsty.
- The patient's appearance is quite characteristic. The skin is pale, although it may later take on an ashen colour. The lips and nails are often bluish in colour. When touching the skin, it is found to be cold and also damp from quite a lot of perspiration.
- The eyes are sunken, with dilated pupils and a glassy or vacant look. Vision is blurred.
- Nausea and vomiting are frequently present. As the state of shock progresses, there is an increasing immobility, indifference and apathy. Sometimes, before reaching this state, there is a period of restlessness. Breathing is shallow and sometimes accelerated.
- The pulse is rapid and weak, sometimes very difficult to feel. If the ear is placed on the chest, the sounds produced by the heart are heard weakly or muffled.
- When a patient with traumatic shock has his blood pressure taken, it is found to be very low.
- The axillary temperature is 1 to 2 degrees lower than normal, and the rectal temperature 1 degree lower than normal.
- In the case of shock caused by hemorrhage, breathing is usually deep and the patient is nervous and fearful rather than indifferent.
CAUSES OF SHOCK
What are the causes of shock? Much has been discussed and is still being discussed about it. However, there is one point on which most researchers agree.
Of the three essential elements in circulation: heart, blood vessels and blood, the one that fails in shock is the second, that is, the blood vessels. There is a failure in the functions of the peripheral vascular system.
For many years, it was believed that the mechanism of shock was explained by a marked dilation of all internal vessels, mainly in the abdominal viscera. When the vessels dilate, blood would accumulate in them, leaving little to circulate.
However, research carried out in recent years seems to indicate that there is no increase in the calibre of the vessels, but rather a narrowing of certain parts of them, associated with a notable increase in the permeability of the vessels, which would allow the blood plasma to escape into the tissues.
This would cause a large decrease in blood volume, which the heart tries to compensate for by beating more frequently, without, however, managing to bring a sufficient quantity of blood to the organs, mainly those of the nervous system.
This insufficient irrigation of the centers of the nervous system that regulate the various functions of the organism would explain the failure of the same.
TYPES OF SHOCK
In addition to traumatic shock, which we discuss in this article, there are other types of shock, which we will mention below.
- Cardiogenic shock: caused by a myocardial infarction.
- Septic shock: caused by a very intense infection.
- Hypovolemic shock: due to loss of a large amount of blood or plasma or also due to dehydration.
- Shock due to burns.
- Shock caused by a lung disease.
WHAT IS FIRST AID IN CASE OF SHOCK?
The first action to take to help a patient in shock is that we must act quickly to save the patient's life. Call a doctor while first aid in case of shock is administered and emergency treatment, as described below. The general care for shock may include:
- Lay the trauma patient down with his head lower than his feet. Raising the skin off the bed about 30 cm with blocks of wood or some bricks will do the trick. This is done to allow as much blood as possible to reach the head and main nerve centres. Do not allow the patient to sit or move around much.
- Try to prevent the patient from getting cold. Cover him with blankets to prevent him from getting cold. If he is on something cold, such as a bench, a stretcher, the floor, etc., do not forget to place blankets under the trauma patient. If there are few blankets, newspapers can be placed between them to prevent heat loss.
- If the patient is very cold, put hot water bottles on him, but be careful not to burn him and especially not to raise the temperature of the skin too quickly, as according to recent research this could aggravate the shock.
- If the patient is conscious, you can give him hot liquids, especially strong coffee, which acts as a stimulant. Before giving it to the patient, be almost certain that he or she does not have a serious abdominal injury, or that he or she will not need general anesthesia soon.
- One of the best ways to provide fluids and salts to the body in these cases is to give water to which one teaspoon of fine salt and half a teaspoon of baking soda have been added per liter of water.
- Stopping any bleeding, if any, is the only treatment allowed for the wound while the state of shock persists.
- Other useful measures are: loosening the collar, belt, girdle, or any other article of clothing that may impede circulation or breathing. Give fresh air, but avoid strong currents that cool the injured person.
- Move the person in shock as little as possible. If you have to do it, do it as gently as possible.
HOW TO AVOID A SHOCK
To avoid a potentially complicated shock, the following suggestions should be followed:
- Lower the injured person's head.
- Avoid cooling the injured person.
- Relieve the pain.
- If for some reason the head cannot be lowered, a similar effect can be obtained by raising the skin and legs.
