Shock

Shock is a life-threatening condition that occurs when the body is not getting enough blood flow. This can damage multiple organs. Shock requires immediate medical treatment and can get worse very rapidly.

Major classes of shock include:

• Cardiogenic shock (associated with heart problems)
• Hypovolemic shock (caused by inadequate blood volume)
• Anaphylactic shock (caused by allergic reaction)
• Septic shock (associated with infections)
• Neurogenic shock (caused by damage to the nervous system)

Shock can be caused by any condition that reduces blood flow, including:

• Heart problems (such as heart attack or heart failure)
• Low blood volume (as with heavy bleeding or dehydration)
• Changes in blood vessels (as with infection or severe allergic reactions)

Shock is often associated with heavy external or internal bleeding from a serious injury. Spinal injuries can also cause shock.

Toxic shock syndrome is an example of a type of shock from an infection.

• Call 911 for immediate medical help.
• Check the person's airways, breathing, and circulation. If necessary, begin rescue breathing and CPR.
• Even if the person is able to breathe on his or her own, continue to check rate of breathing at least every 5 minutes until help arrives.
• If the person is conscious and does NOT have an injury to the head, leg, neck, or spine, place the person in the shock position. Lay the person on the back and elevate the legs about 12 inches. Do NOT elevate the head. If raising the legs will cause pain or potential harm, leave the person lying flat.
• Give appropriate first aid for any wounds, injuries, or illnesses.
• Keep the person warm and comfortable. Loosen tight clothing.

IF THE PERSON VOMITS OR DROOLS

• Turn the head to one side so he or she will not choke. Do this as long as there is no suspicion of spinal injury.
• If a spinal injury is suspected, "log roll" him or her instead. Keep the person's head, neck, and back in line, and roll him or her as a unit.

• Do NOT give the person anything by mouth, including anything to eat or drink.
• Do NOT move the person with a known or suspected spinal injury.
• Do NOT wait for milder shock symptoms to worsen before calling for emergency medical help.

Marx JA, Hockberger RS, Walls RM, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 5th ed. St. Louis, Mo: Mosby; 2002.

Goldman L, Ausiello D, eds. Cecil Medicine.23rd ed. Philadelphia, Pa: Saunders; 2004.