Shock

Shock is a life-threatening emergency in which the body's organs aren't getting enough blood and oxygen. It can develop quickly and requires immediate hospital treatment — dial 112. Shock is not the same as an emotional reaction or fainting — it's a medical condition in which the circulation is failing.

Types of shock

• Hypovolaemic shock — from loss of blood or fluids (severe bleeding, severe dehydration from cholera/gastroenteritis, burns)
• Cardiogenic shock — the heart isn't pumping effectively (severe heart attack, severe arrhythmia, advanced heart failure)
• Distributive shock — blood vessels dilate too widely; includes:
• · Septic shock — from severe infection
• · Anaphylactic shock — severe allergic reaction
• · Neurogenic shock — from spinal cord injury
• Obstructive shock — blood flow mechanically blocked (massive pulmonary embolism, cardiac tamponade, tension pneumothorax)

Signs of shock

• Rapid, shallow breathing
• Fast, weak pulse
• Cold, pale, clammy skin; bluish lips or nails in late shock
• Low blood pressure — dizziness, fainting
• Confusion, unusual drowsiness, or agitation
• Very low urine output
• Weakness, feeling of impending doom
• Specific additional signs — e.g. heavy bleeding, swelling after insect sting, fever with rigors (sepsis)

If you suspect shock, call 112 immediately. Shock is always a medical emergency.

What to do while waiting

• Lay the person flat, with legs raised slightly if no spinal injury is suspected
• Don't give food or drink — the person may need urgent surgery or anaesthesia
• Keep the person warm with a blanket
• Control visible bleeding with firm pressure
• If in anaphylaxis and the person has an adrenaline auto-injector (EpiPen), use it as trained
• If unconscious and not breathing normally, start CPR
• Note the time symptoms started and any known allergies, medicines, or events (fall, bite, procedure)

Hospital treatment

Depends on cause but typically includes IV fluids, oxygen, emergency surgery for bleeding, antibiotics and fluids for sepsis, adrenaline for anaphylaxis, heart medicines or urgent procedures for cardiogenic shock. Treatment happens rapidly, often in intensive care. Early recognition and treatment transform survival.