What is shock
A shock could be a grave condition characterized by cardiovascular disease. If not treated straight away, it results in death inevitably.
- The low vital sign (systolic BP below eighty mmHg) is that the crucial sign of shock
- Weak and rapid pulse
- Rapid and shallow breathe
- Restlessness and altered mental state
- Low urine output
Signs and symptoms of trauma in children must be recognized while still in the compensated country to avoid irreversible deterioration. Therefore, the following primarily assess in children:
- The Prolonged capillary filling (more than 3 seconds)
- (weak thread pulse)Decreased pulse volume
- Increased the heart rate (>160/minute in infants, > 120 in children)
- (poor eye contact)Decreased level of consciousness
- Rapid breathing
- Reduced blood pressure and decreased urine output are late signs, and while they can monitor the above symptoms are more sensitive in detecting shock before irreversible.
Types of Shock
|Type of Shock||Explanation||Additional symptoms|
|Hypovolemic||A most common type of shock|
The primary cause is a loss of fluid from circulation due to illness, burns, diarrhea, etc.
|Weak thread pulse, cold, and clammy skin.|
|Cardiogenic shock||Because of the failure of the heart to pump effectively, e.g., in myocardial infarction, cardiac failure, etc.||Distended neck veins, weak or absent pulses|
|Septic shock||Caused by overwhelming infection, leading to vasodilatation.||Elevated by body temperature|
|Neurogenic shock||Because of the trauma to the spinal cord, resulting in a sudden decrease in peripheral vascular resistance and hypotension.||Warm and dry skin|
|Anaphylactic shock||Caused by a severe allergic reaction to an allergen or drug.||Bronchospasm, angioedema, and|
- Emergency treatment
Treatment depends on the type of shock. Intravenous fluid therapy is essential in the treatment of all kinds of trauma except for cardiogenic shock. Prompt diagnosis of the underlying cause is necessary to ensure optimal treatment.
- Maintain open airway
- Administer oxygen with a face mask and if needed after intubation with assisted ventilation
- Check for and manage hypoglycemia
- Fluid replacement (Not for Cardiogenic shock) Adults:
A: 0.9% Sodium chloride gave as the 1L bolus infusion. Repeat bolus until blood pressure is improved.
Transfuse blood and plasma expanders in hemorrhagic shock.
A: 0.9% Sodium chloride of 20 mol/kg as a slow infusion. Note
- Do not administer the IV fluids in case of Cardiogenic shock but maintain IV access
- If a patient develops respiratory distress, discontinue fluids
- Septicemia in children. All children with a shock, which is not apparent owing to trauma or simple watery diarrhea, should receive antibiotic cover for probable sepsis.
B: The Ampicillin 20mg/kg/dose 6 hourly for 7-10 days
C: The Ceftriaxone, IM, 50–80 mg/kg/dose immediately as a single dose.
Instructions For Mixing Injection with Water
|Dose mg||Use one of the following injections to mixed with water for |
|500mg WFI 2ml||1000mg |
|>2 – 2.5 kg||125 mg||1 ml||0.5 ml||–|
|>2.5 – 3.5 kg||200 mg||1.6 ml||0.8 ml||–||Birth – 1 month|
|>3.5 – 5.5 kg||250 mg||2 ml||1 ml||–||> 1 – 3 months|
|>5-7 kg||375 mg||3 ml||1.5 ml||–||>3 – 6 months|
|>7-9 kg||500 mg||4 ml||2 ml||–||>6 – 12 months|
|> 9-11 kg||625 mg||5 ml||2.5 ml||–||>12 – 18 months|
|>11-14 kg||750 mg||6 ml||3 ml||–||>18 months – 3years|
|>14-17.5 kg||1000 mg||–||4 ml||3.5 ml||>3 – 5 years|
|>17.5 kg and above||1000 mg||–||4 ml||3.5 ml||Five years and above|
- Do not administer fluids containing a metallic element, e.g., Ringer-lactate, at intervals forty-eight hours of applying Rocephin
- Contra-indicated in the neonatal jaundice
- Annotate dose and route of the administration on referral letter.
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