1. SHOCK Sudden collapse of circulation is called shock and is one of the most formidable conditions in clinical practice Sudden collapse of circulation is called shock and is one of the most formidable conditions in clinical practice CAUSES CAUSES 1. Hemorrhage 2. Severe wounds 3. Severe burns 4. Multiple fractures 5. Pulmonary embolism 6. Myocardial infarction 7. Severe infection 8. Severe allergic reaction

2. SIGNS AND SYMPTOMS Apprehension,light headedness Apprehension,light headedness Generalized itching Generalized itching Swelling of eyelids and lips, tongue hands and feet Swelling of eyelids and lips, tongue hands and feet Skin colour pale and grey,slow capillary refill of nail beds Skin colour pale and grey,slow capillary refill of nail beds Cool moist skin Cool moist skin Weak rapid pulse Weak rapid pulse Fast shallow breathing Fast shallow breathing Low blood pressure Low blood pressure

3. TYPES OF SHOCK Hypovolemic-blood or plasma is lost from circulation to exterior or into the tissues Hypovolemic-blood or plasma is lost from circulation to exterior or into the tissues Cardiogenic-failiure of pumping action of the heart causing inadequate circulating blood volume Cardiogenic-failiure of pumping action of the heart causing inadequate circulating blood volume vasogenic or low resistance shock- widespread vasodilation causing increased capacity of circulation vasogenic or low resistance shock- widespread vasodilation causing increased capacity of circulation

4. Septic- caused by overwhelming infection Septic- caused by overwhelming infection Anaphylactic – severe allergic reaction produced by the injection of a protein to which a person is sensitive. E.g penicillin, anesthetic agent Anaphylactic – severe allergic reaction produced by the injection of a protein to which a person is sensitive. E.g penicillin, anesthetic agent Neurogenic- loss of sympathetic control can result from spinal anesthesia Neurogenic- loss of sympathetic control can result from spinal anesthesia

5. TREATMENT The patient should be laid flat, preferably in the head down position which improves brain circulation The patient should be laid flat, preferably in the head down position which improves brain circulation Depending on the type of shock the volume of circulating blood must be increased as quickly as possible by IV infusion Depending on the type of shock the volume of circulating blood must be increased as quickly as possible by IV infusion Venous blood must be taken for grouping and cross matching in severe cases of hypovolemic shock Venous blood must be taken for grouping and cross matching in severe cases of hypovolemic shock Fluids must be administered. Ringer lactate or normal saline until medical help arrives Fluids must be administered. Ringer lactate or normal saline until medical help arrives Injection adrenaline 1amp sub cutaneously is the drug of choice in anaphylactic shock Injection adrenaline 1amp sub cutaneously is the drug of choice in anaphylactic shock

6. SUMMARY The major systemic complications of asthma, diabetes, hypertension,cardiac arrest and shock have been described The major systemic complications of asthma, diabetes, hypertension,cardiac arrest and shock have been described Key points to remember Key points to remember 1. Cardiac arrest is a life threatening condition 2. Resuscitation must be started immediately 3. Shock has many causes