Medical Shock

  • Medical Author:
    John P. Cunha, DO, FACOEP

    John P. Cunha, DO, is a U.S. board-certified Emergency Medicine Physician. Dr. Cunha's educational background includes a BS in Biology from Rutgers, the State University of New Jersey, and a DO from the Kansas City University of Medicine and Biosciences in Kansas City, MO. He completed residency training in Emergency Medicine at Newark Beth Israel Medical Center in Newark, New Jersey.

  • Medical Editor: William C. Shiel Jr., MD, FACP, FACR
    William C. Shiel Jr., MD, FACP, FACR

    William C. Shiel Jr., MD, FACP, FACR

    Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

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When should I seek medical care for shock?

Medical shock is a medical emergency. If you suspect shock after an injury, even if the person seems stable, call 911 or get them to an emergency department immediately. Prompt treatment can save a person's life.

The sooner shock is treated, the better. When treated quickly there is less risk of damage to a person's vital organs.

What is the treatment for shock?

Depending on the type or the cause of the shock, treatments 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, and if possible, stay on the line with the 911 dispatcher because they may have specific instructions for you.
  • 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 2 minutes until help arrives.
  • Do NOT move a person who has a known or suspected spinal injury (unless they are in imminent danger of further injury).
  • 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.
  • 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.
  • Direct pressure should be applied to any wounds that are bleeding significantly.
Medically Reviewed by a Doctor on 2/5/2015
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