Shock (cont.)
What is the treatment for shock?
Depending on the type or the cause of the shock, treatments will differ. In
general, fluid resuscitation (giving a large amount of fluid to raise blood
pressure quickly) with an IV in the ambulance or emergency room is the
first-line treatment for all types of shock. The doctor will also administer
medications such as epinephrine, norepinephrine or dopamine to the fluids to try
to raise a patient's blood pressure to ensure blood flow to the vital organs.
Tests (for example, x-rays, blood tests,
EKGs) will determine the underlying cause
of the shock and uncover the severity of the patient's illness.
Septic shock is treated with prompt administration of antibiotics depending
on the source and type of underlying infection. These patients are often
dehydrated and require large amounts of fluids to increase and maintain blood
pressure.
Anaphylactic shock is treated with
diphenhydramine (Benadryl),
epinephrine
(an "Epi-pen"), steroid medications
methylprednisolone (Solu-Medrol)
and sometimes a H2-Blocker medication [for example,
famotidine (Pepcid),
cimetidine (Tagamet), etc.].
Cardiogenic shock is treated by identifying and treating the underlying
cause. A patient with a heart attack may require a surgical procedure called a
cardiac catheterization to unblock an artery. A patient with congestive heart
failure may need medications to support and increase the force of the heart's
beat. In severe or prolonged cases, a heart transplant may be the only
treatment.
Hypovolemic shock is treated with fluids (saline) in minor cases, but may
require multiple blood transfusions in severe cases. The underlying cause of the
bleeding must also be identified and corrected.
Neurogenic shock is the most difficult to treat. Damage to the spinal cord is
often irreversible and causes problems with the natural regulatory functions of
the body. Besides fluids and monitoring, immobilization (keeping the spine from
moving), anti-inflammatory medicine such as steroids, and sometimes surgery are
the main parts of treatment.
Self-Care at Home
- Call 911 for immediate medical attention any time a person has symptoms of
shock. Do not wait for symptoms to worsen before calling for help. Stay with the
person until help arrives.
- While waiting for help or on the way to the emergency room, check the
person's airway, breathing and circulation (the ABCs). Administer CPR if you are trained.
If the person is breathing on his or her own, continue to check breathing every
five minutes until help arrives.
- Have the person lie down on his or her back with the feet elevated above
the head (if raising the legs causes pain or injury, keep the person flat) to
increase blood flow to vital organs. Do not raise the head.
- Do NOT move a person who has a known or suspected spinal injury.
- Keep the person warm and comfortable. Loosen tight clothing and cover them
with a blanket.
- Do not give fluids by mouth, even if the person complains of thirst. There
is a choking risk in the event of sudden loss of consciousness.
- Give appropriate first aid for any injuries.
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