What is shock

A shock could be a grave condition characterized by cardiovascular disease. If not treated straight away, it results in death inevitably.

Diagnosis

  • 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
  • Weakness
  • Low urine output

Note 

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

urticaria

Shock: Symptoms, Causes & Treatments-[2019]
Shock: Symptoms, Causes & Treatments-[2019]
  1. 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

 

  1. 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.

To Children:

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

OR trauma

C: The Ceftriaxone, IM, 50–80 mg/kg/dose immediately as a single dose.

Instructions For Mixing Injection with Water

 

 

Weight kg

Dose mg Use one of the following injections to mixed with water for

injection (WFI)

 

 

Age/Months/year

250mg

 

500mg WFI  2ml 1000mg

WFI

3.5ml

>2 – 2.5 kg 125 mg1 ml0.5 ml
>2.5 – 3.5 kg 200 mg1.6 ml0.8 mlBirth – 1 month
>3.5 – 5.5 kg 250 mg2 ml1 ml> 1 – 3 months
>5-7 kg 375 mg3 ml1.5 ml>3 – 6 months
>7-9 kg 500 mg4 ml2 ml>6 – 12 months
> 9-11 kg 625 mg5 ml2.5 ml>12 – 18 months
>11-14 kg 750 mg6 ml3 ml>18 months – 3years
>14-17.5 kg 1000 mg4 ml3.5 ml>3 – 5 years
>17.5 kg and above 1000 mg4 ml3.5 mlFive years and above

! CAUTION!

  • 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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