treatment of shock.pdf

Shock is a critical condition brought on by the sudden drop in blood flow through the body. Shock may result from trauma, heatstroke, blood loss, an allergic reaction, severe infection, poisoning, severe burns or other causes. When a person is in shock, his or her organs aren't getting enough blood or oxygen.

2. I would like to express my special thanks of gratitude
to my teacher DR. VIR VIKRAM (HOD pharmacology)
as well as DR. LOVEPREET SINGH (Assistant professor )
who gave me golden opportunity to do this
wonderful project on the topic TREATMENT OFSHOCK
which also helped me in doing a lot of research and I learnt so much about the topic .
I am really thankful to them .
Secondly , I would also like to thank my friends who
helped me a lot in finishing this project within limited
time.
It helped me increase my knowledge and my skills .
THANKS AGAIN TO ALL WHO SUPPORTED

3. Shock occurs when there is a severe
decrease in tissue perfusion. The important
manifestations of shock are:
1.Hypotension
2.Tachycardia
3.Thready pulse
4.Pale
5.Cold and clammy skin
6.Hypoventilation
7.Oliguria

8.Clouding of consciousness ,etc.

4. Hypovalaemicshock –Haemorrhage
,Burns,Severevomiting and diarrhoea,
diabetic ketoacidosis,etc
Cardiogenicshock-Acute myocardial
infarction,Arrhythmias,etc.
Septic shock-Serious bacterial infections;most
commonly gram- negative infections
Neurogenicshock-Traumatic spinal cord injury ,
spinal aesthetics,etc.

Anaphylactic shock-Drugs like
penicillin,lignocaineetc.,beesting, shell fish
,etc.

7. In Hypovalaemicshock ,there is a
decrease in circulating blood volume.
Cardiogenicshock is due to pump
failure.
In septic,anaphylacticand neurogenic
shock, there is a decrease in systemic
vascular resistance leading to low output
and tissue underperfusion.
.

8. General measures:
1.Maintain airway and breathing. Oxygen inhalation
–if necessary,artificialventilation.
2.Establish i.v.line,maintain fluid and electrolyte
balance.
3.Collect blood sample for blood count , culture
, electrolytes,glucose,bloodgas analysis,grouping
and cross-matching
4.Monitor heart rate,BP,urineoutput,levelof
consciousness ,respiration,centralvenous pressure,etc

5.Intrsvenous sodium bicarbonate to correct acidosis
,if any.
~further treatment depends upon the type of shock

12. Achieve haemostasisin case of haemorrhagic
shock.
Intravenous fluids are used to restore the loss for
example,Dextrose,normalsaline ,ringer
lactase,dextran.
Blood transfusion in case of acute
haemorrhage.

In patients with hypovalemicshock due to fluid
losses –2 litresof isotonic crystalloid solution is
infused rapidly as an attempt to quickly restore
tissue perfusion.
.

13. CRYSTALLOID FLUIDS- they are the subset of
intravenous solutions that are frequently
used in clinical setting , they are the FIRST
CHOICE FOR FLUID RESUSCITION IN THE
PRESENCE OF HYPOVALEMIA ,
HEMORRHAGE,SEPSIS AND DEHYDRATION.
MEDICINES- Dopamine, Dobutamine,
Epinephrine, and Norepinephrinemay be
needed to increase the blood pressure and the amount of blood pumped out of the heart i.e, the cardiac output

17. A widespread infection causing organ
failure and dangerously low blood
pressure.
Septic shock is a life threatening
condition caused by severe localisedor
system-wide infection that requires
immediate medical attention.
Intravenous fluids are given with
complete monitoring .

18. Antibiotics:Empericaltherapy should be
started early to treat infection.

Activated protein Cis administered by i.v
route
Activated protein C has antithrombic,
fibrinolytic,andanti-inflammatory
activities. It is given to patients with
severe sepsis and organ failure.

.

19. Glucocoticoids:Their role is controversial . i.v
hydrocortisone may be helpful in patients with
septic shockinadrenal insufficiency.
Vasopressors:like phenylepherineand
noradrenalineare used, they are administered
as i.vinfusion.
MEDICINES-Vasoconstrictors are used for
narrowing the blood vessels
-Penicillin is used to kill specific bacterias.
-Antibiotics are given to stop the growth or kill
the bacterias .eg, metronidazole, furazolidone,
deptomycin,tigecycline,erythromycin

23. MACHANISM OF ACTION -
Exposure to certain drugs
(penicillin,aspirin,lignocaine.)
Production of IgGantibodies-fix to
mast cell
On re-exposure to the same drug

24. Ag-Ab reaction occurs on the mast
cell surface
Mediators are released
(Histamine,5-HT,PGs,LTs,PAF)
Hypotension , bronchospasm,
angioedema,urticaria, rhinitis , and
anaphylactic shock.

25. TREATMENT- Inj.adrenaline(1:1000) 0.3- 0.5 ml
intramuscularly.
2.Inj.hydrocortisone 100-200mg intravenously.
3.Inj.pheniramine 45mg
intramuscularly/intravenously.
4.intravenous fluids are given.

ADRENALINE IS A LIFE SAVING DRUG AS IT
RAPIDLY REVERSES ALL THE SEVERE ALLERGIC
REACTIONS.


29. Life threatening condition in which the heart
suddenly cannot pump enough blood to meet
the body`s needs.
Condition is caused by a severe heart attack ,but not everyone who has heart attack has
cardiogenicshock. It is a rare condition.
Although the chances of survival have improved over time, 50% to 75% of people don’t survive it .
Without and even with the treatment the
condition can be fatal.
PEOPLE WHO ARE AT THE RISK :

30. AGE:people who are 75 or older.
RACE OR ETHNICITY: Asian Americans
and Pacific Islanders have a higher risk of
cardiogenicshock than other racial or
ethnic groups.

Pulmonary thromboembolismis
common in the hypercoagulability
state provoked by COVID-19 and can
lead to cardiogenicshock with high
mortality.

31. 1.Vasopressors:Dopamine,dobutamine,and
noradrenalinecan be used usedas i.vinfusion.
2.Blood thiningagents:Aspirin
3.Reperfusion by PCI/coronary artery
bypass/thrombolytics.
4.Pain and anxiety are relieved by i.v
morphine.
5.Treat arrhythmias with drugs or pacing.
6.Intravenous heparin.

7.The goal of cardiogenicshock treatment is to
quickly restore blood pressure and heart
function.

35. it is a condition in which you have trouble keeping
your heart rate,bloodpressure and temperature
stable because of damage to your nervous system
after a spinal cord injury. Like other types of shock ,
this is a serious condition that can be fatal because
your blood flow is too low.
-Car accidents that can cause central nervous
system damage or spinal cord injury.
-Sport injuries causing trauma to spine,gunshot
wounds to the spine.

-medications that affect the autonomic nervous system , which regulates breathing and other
automatic bodily functions.

36. SIGNS AND SYMPTOMS –
Low blood pressure –hypotension.
Slow heart rhythm-bradyarrhythmia.
Flushed,warmskin that gets cold clammy later.
Lips and fingernails that looks blue.
Lack of full consciousness.
TREATMENT-1.Establish airway.
2.Oxygen to be administered.
3.Fluid resuscition,blood transfusion,useof
vasopressors
4.Immobility of neck and body(if there is spinal injury).


39. :TARA V SHANBHAG
:KD TRIPATHI
:WIKIPEDIA