Leukemia (Blood Cancer)

 

Today's topic is Shock! 

               Shock is a medical condition that arises when the tissues in the body do not receive sufficient blood flow as a result of problems with the circulatory system, lack of blood flow means a lack of oxygen and nutrients to allow the cells in the body to function properly. Medical shock is a medical emergency and requires immediate treatment as systems can worsen rapidly treating shock immediately can be life-saving.

Medical shock is totally different from an emotional or psychological shock that can occur from a traumatic or frightening emotional event there were four stages of shock

(1) Initial Stage.

(2) Compensatory Stage.

(3) Progressive Stage.

(4) Refractory Stage.

 

At the initial stage, cells begin to change as a result of perfusion and oxygenation perfusion refers to the process by which the veins deliver blood to the capillary beds within the body tissues this further results in the cells using anaerobic without oxygen metabolism to function instead of the aerobic with oxygen metabolism lactic acid and pyruvic acid are formed as a byproduct of anaerobic metabolism this initial stage of shock is reversible but does not show any obvious symptom that would signal that the body is entering a stage of shock.

During the compensatory stage the body employs physiological mechanisms including a neural hormonal and biochemical mechanism to reverse the result of the initial stage, hyperventilation is one of these mechanisms during hyperventilation there is an increased rate of breathing which improves oxygen flow to the cells this helps to neutralize the acidic condition and raise the pH of the blood another mechanism used by the body is referred to as the catecholamine response, Catecholamines are hormones that are released by the adrenal gland and are triggered by low blood pressure caused by the reduced volume of blood flow these hormones aim to increase the heart rate in order to increase blood pressure the rayon Angiotensin response is another mechanism used by the body during the response vasopressin is released into the bloodstream to help conserve fluid via the kidneys and triggers vasoconstriction of the kidneys, GI tract and other organs to divert blood to the heart, lungs and brain as anaerobic mechanism continues the body's metabolic acidosis increases cellular function deteriorates and the compensatory mechanism begins to fail and is not able to maintain the balance needed to protect the organs.

During the refractory stage the body enters the last stage of shock the organs fail and death may follow causes the underlying cause has been divided into four main parts cardiogenic shock which may be due to damage to the heart from myocardial infarction dysrhythmias congestive heart failure cardiomyopathy or valvular heart disease hypovolemic shock is the most common type and results from severe external or internal bleeding, dehydration, kidney failure, inflammation of the pancreas, extensive Burns or diabetes insipidus.

The distributive shock may include septic shock caused by bacteria such as Escherichia coli, Proteus species, klebsiella, and ammonia.

Anaphylactic shock is caused by reactions to allergens antigen drug or foreign protein that causes the release of histamine.

Neurogenic shock occurs from high spinal cord injuries or trauma.

The obstructive shock that may result from conditions such as tension pneumothorax

Aortic stenosis and pulmonary embolism.

Symptoms pale skin, rapid pulse, rapid breathing, weakness or fatigue, dizziness, nausea or vomiting, enlarged pupils, cool clammy skin, thirst and dry mouth feeling anxious, agitated or confused profuse sweating.

Diagnosis and treatment! diagnosis is generally based on a combination of symptoms physical examination and laboratory tests x-ray blood tests EKGs to determine the underlying cause of the shock and the severity of your illness. Treatment! Treatment is based on the underlying cause the first course of action is to give fluid resuscitation this means that a large amount of water is given with an IV whether in an ambulance or emergency room to raise the blood pressure medications such as epinephrine dopamine may be administered along with the fluid to try to raise blood pressure and ensure blood flows to the treatment of the vital organ may also include securing the airway if necessary to decrease the work of breathing and to guard against respiratory arrest. Septic shock is treated with quick administration of antibiotics depending on the source and type of the infection causing the shock. In minor cases, hypovolemic shock is treated with fluids but may require multiple blood transfusions in severe cases.  

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