Symptoms And Treatment Of Shock

JM is very healthy young boy with no history of any complication disease. He has allergy to peanuts. JM’s mother said if he eats peanuts he starts itching and his eczema start. No known drug allergies. He does not take any routine medication. JM has never been hospitalization. His mother states that JM is up to date with the immunizations and last time to see his physician was December last year for year checkup and he see his dentist every six months.

According to information published by the Mayo Clinic, sepsis has three stages: sepsis, severe sepsis and septic shock. The mortality rate for septic shock is nearly 50 per cent, and an episode of severe sepsis increases the risk of future infections. Severe sepsis causes blood flow to the vital organs, such as the brain, heart and kidneys, to become impaired. Sepsis can also cause blood clots to form in organs and extremities such as arms, legs, fingers and toes, which can lead to organ failure and tissue death (gangrene).

Cardiogenic shock is results from damage to the heart such as a heart attack. In cardiogenic shock the heart is damaged and unable to supply a sufficient amount of blood to the body and the body cells do not receive enough oxygen (Huether & Mccance, 2012). Symptoms of cardiogenic shock are chest pain or pressure, coma, decreased urination, fast breathing, fast pulse, heavy sweating and moist skin, lightheadedness, loss of alertness and ability to concentrate, restlessness, agitation, confusion, shortness of break, skin that feels cool to touch, pale skin color or blotchy skin, and/or weak pulse (Dugdale, Cardiogenic Shock, 2012). Treatment of cardiogenic shock includes medications to increase blood pressure sucj as dobutamine, dopamine, milirione, and more. Urgent treatment includes electrical shock therapy (defibrillation or cardio version), implanting a temporary pacemaker and medications given through the vein, pain medicine, oxygen, fluids, and blood or blood products (Dugdale, Cardiogenic Shock, 2012). Cardiogenic shock

Septic shock is a subset of severe sepsis and was defined as “sepsis-induced hypotension persisting despite adequate fluid resusci- tation” (see Fig. 12.1). While the quantity of fluid that qualifies as “adequate fluid resuscitation” is controversial, we believe septic shock is best defined as a “mean arterial pressure (MAP) less than 65 mmHg after a fluid challenge of 20 mL/Kg body weight (given 30–60 minutes) in patients with sepsis and in the absence of other causes for hypotension” (also see Chap. 14). According to the ACCP/SCCM defini- tions, three stages in the hierarchy of the host’s response to infection were recognized, namely, sepsis, severe sepsis and septic shock, with sepsis having the best prognosis and septic shock the worst. While the use of the SIRS criteria to define sepsis is some- what controversial [3–6], many consider sepsis to be best defined as the “systemic response to infection with the presence of some degree of organ dysfunction”

Sepsis is a phenomenon in which an infective agent results in a physiological response in excess of the pathogenic insult. Efforts to define and investigate sepsis have been somewhat fruitful in elucidating the nuances of this phenomenon. Yet, gaps exist in identifying and investigating sepsis. Recent efforts have streamlined the definition and identification criteria of sepsis and septic shock. The treatment of sepsis is based on the elements of identification, hemodynamic interventions (fluid and vasopressor resuscitation), and antimicrobial therapy/source control. A two-tiered approach employing the qSOFA (Quick Sepsis-Related Organ Failure Assessment) and SOFA (Sepsis-Related Organ Failure Assessment) tools now provide a succinct criteria for sepsis and septic shock. Various approaches may be taken to assess fluid responsiveness, provide fluid resuscitation, and determine the need for vasopressor support. Early, aggressive antimicrobial therapy is essential to the treatment of sepsis. Obtaining source control and considering early surgical

Shock is a collapse of Circulatory function caused by severe injury, blood loss, or disease, and characterized by pallor sweating, weak pulse, and very low blood pressure .There are three basic types of shock. Cardiogenic Shock [includes tension pneumothorax, cardiac tamponede and pulmonary embolism] which is caused by the heart failing to pump as designed. Distributive shock [includes septic shock, neurogenic shock, anaphylactic shock and psychogenic shock] which is caused by poor vessel function. Lastly we have hypovolemic shock [includes hemorrhagic shock and non hemorrhagic shock]. Cardiogenic shock is basically shock that is cardiac in nature. It is also the end off of the road for all other causes of shock. Cardiogenic shock

Septic shock is the stage of sepsis when multiple organ failure is evident and uncontrolled bleeding of the body occurs. Septic shock results from the complication of an infection where toxins initiate a full body inflammatory response. Viral, fungal, and bacterial infections can all lead to septic shock, but the most common causes of sepsis are gram- negative bacteria and gram-positive bacteria. Sepsis causes severe hypovolemic shock and hypodynamic cardiac function to affect the body, platelets and clotting factors are consumed and thus the body cannot clot blood. Capillary leak occurs and cardiac contractility is poor from cellular ischemia (Ignatavicius & Workman, 2011). For a person to be diagnosed with septic shock, they must have symptoms

Hypovolemic shock occurs when there is an overall “loss in circulatory volume”, which means not enough blood is circulating through the body. Cardiogenic shock occurs when the heart cannot provide enough blood to maintain the organs of the body. Distributive shock occurs when the volume of blood is at a normal level, however the distribution of the blood is abnormal. Finally, extracardiac

Kleinpell states, “Septic shock is the result of an overwhelming infection, leading to hypotension, altered coagulation, inflammation, impaired circulation at a cellular level, anaerobic metabolism, changes in mental status and multiple organ failure (as sited in Garretson & Malberti, Ignatavicius and Workman (2009), “sepsis is a widespread infection coupled with a more general criteria: body temperature higher than 380C or lower than 360C, heart rate greater than 90 beats per minute, respiratory rate greater than 20 breaths per minutes, and WBC count greater than 12,000/mm or lower than 4,000/mm or with more than 10% bands (Spaniol, Knight, Zebley, Anderson, Pierce, 2007). Endotoxins from gram-negative bacteria, such as Escherichia coli, can precipitate the common progression of events leading to septic shock. A patient experiencing SIRS is at risk for organ failure (severe sepsis), multiple organ dysfunction syndrome, and death. This paper will outline the details surrounding this condition, from a nursing standpoint.

Signs and Symptoms – During the SIRS stage signs and symptoms will include a temperature below 36oC or above 38oC, an increased respiratory rate (above 20/min), and an increased heart rate (above 90/min). During simple sepsis the patient will present with at least 2 or more SIRS criteria and an infection. During severe sepsis acute organ failure of one or multiple organs will occur so sign and symptoms will include: hypoxemia, altered level of consciousness, cardiac insufficiency, respiratory insufficiency, difficulty urinating, and impaired coagulation of blood. During septic shock the patient has severe sepsis, but also has inadequate tissue perfusion and a low blood pressure. Other signs and symptoms include: diaphoresis, nausea, vomiting, and a blood glucose level above 7.7mmol/L in patients who are not

Hypovolemic shock “is an emergency condition in which severe blood and fluid loss make the heart unable to pump enough blood to the body” ( Heller). Hypovolemic shock can be a result of numerous things such as dehydration, excessive diarrhea or bleeding (Nall). Excessive bleeding, both externally and internally, due to injuries is known as Hemorrhagic shock. Hemorrhagic shock is a type of hypovolemic shock that is “associated with the sudden and rapid loss of significant amounts of blood” (Dictionary).

Hypovolemic shock is an emergency state in which one loses a large amount of blood or other body fluid. This can then cause the heart to be incapable of pumping enough blood to the rest of the body. Subsequently this can cause many of the body’s other organs to shut down due to shock. Bleeding as such can happen to a woman while pregnant or shortly after delivery.

According to the National Trauma Institute, hypovolemic shock is the second leading cause of death in people with traumatic injuries. [1] This makes the initial identification and management of Hypovolemia detrimental to the outcome and survival of many patients involved in traumatic events. Hypovolemia refers to a medical condition in which rapid fluid loss results in multiple organ failure due to inadequate circulating volume and consecutive inadequate perfusion. [1,2,3]

Toxic Shock Syndrome is a rare, potentially life-threatening, syndrome that was initially discovered and diagnosed in the 1970s. “It is characterized by high fever, rash, hypotension, multi organ failure (involving at least 3 or more organ systems), and desquamation of the skin, typically of the palms of the hands and soles of the feet, 1-2 weeks after the onset of acute illness. The clinical syndrome can also include severe myalgia, vomiting, diarrhea, headache, and nonfocal neurologic abnormalities. (Venkataraman, 2014) ” Toxic Shock syndrome can also lead to surgical debridement and amputation (Willey, 2014).” At time of discovery, toxic shock syndrome was more prevalent amongst women, particularly those who used tampons or intrauterine

“About 70% of all American women use tampons. On average, a woman will use between 11,000and 16,000 tampons in her lifetime”(Kounang). Nearly every person born as a biological female experiences menstruation, more commonly referred to as a period, for one week out of the month, with the typical period lasting 7 days and recurring after 28 days. The aforementioned tampons and sanitary pads are the most common devices to combat periods, but there is a general lack of regulation surrounding these products. To make women aware of the products that are an integral part of their daily lives, the Food and Drug Administration (FDA) should require companies to list all ingredients in feminine hygiene products, and the FDA should put warnings on products