Hypovolemic shock is a clinical, life-threatening emergency. During hypovolemic shock, there is a sharp drop in pressure, and further organ hypoxia. What are the causes and symptoms of hypovolemic shock? What is the treatment?
Hypovolemic shockis caused by a relative or absolute reduction in circulating blood volume. Losing more than 20 percent (one fifth) of your blood or fluid volume is a life-threatening condition. This severe loss of fluid prevents the heart from pumping blood efficiently. There is a massive reduction in systolic blood pressure below 90 mmHg (normally it is about 120 mmHg). Immediate medical intervention is necessary for the patient to survive!
Hypovolemic shock: causes
- loss of whole blood - bleeding, haemorrhage - SHOCK OF SHOCK
- decrease in plasma volume due to:
- plasma escapes to crushed tissues (injuries) or its loss from the skin surface (burns, Lyell's syndrome, Stevens-Johnson syndrome, exfoliative dermatitis) - reduction in extracellular fluid volume (states of dehydration) resulting from either reduced water supply - most often in the elderly (with impaired thirst) and dependent people, or with increased loss of water and electrolytes through the gastrointestinal tract (diarrhea and vomiting), kidneys (osmotic diuresis in diabetic ketoacidosis and non-keto hyperglycemia, polyuria and excessive sodium excretion in glyco-deficiency - and corticosteroid minerals, rarely hypothalamic and renal diabetes insipidus), skin (fever, hyperthermia) or fluid leakage into the so-called the third space - the intestinal lumen (paralytic or mechanical obstruction), less often the serous cavities (peritoneum - ascites) or the increase in the permeability of the vascular wall in anaphylactic and septic shock.
Hypovolemic shock: symptoms
The symptoms of hypovolemic shock vary depending on how severe your fluid loss and / or blood loss is. Symptoms of internal bleeding may be difficult to recognize before you develop symptoms of shock. External bleeding will, however, be visible. Symptoms of hemorrhagic shock may appear delayed. In older adults, symptoms maynot occur until the shock has reached an advanced stage. The main symptoms are:
- weakness
- desire
- pallor
- systolic blood pressure<90 mmHg
- tachycardia
- rapid and shallow breathing (tachypnoe)
- cold, moist skin (capillary return>2 sec.)
- decreased urine output
- confusion, anxiety
Symptoms of internal bleeding include:
- stomach ache
- blood in stool
- hematuria
- vaginal bleeding (heavy, usually more than during a normal period)
- vomiting blood
- chest pain
- abdominal swelling
Hypovolemic shock: first aid
Shock is an immediate life-threatening condition and in any case of suspicion of its occurrence, call for medical assistance. If you are bleeding profusely or if you have symptoms of shock, you should not drive yourself. Do not give the patient any medications or fluids by mouth. In hypovolemic shock from external bleeding, try to stop or limit the bleeding. If the patient loses consciousness, place him in a safe position, the so-called side fixed. It is worth protecting it against cooling down (e.g. by covering it with a thermal blanket). At the same time, be ready to begin CPR (cardiac massage alternating with mouth-to-mouth breathing) in the event of cardiac arrest. However, these activities must not in any way delay calling for qualified help or transporting the patient to the hospital.
Hypovolemic shock: prognosis
Hypovolemic shock without medical intervention is fatal. A lack of blood or fluid in the body can damage organs such as the kidneys and the brain. Limb gangrene or heart attack may occur. The effects of a hypovolemic shock depend on the amount of blood and / or fluid lost, how quickly it is lost, and the extent of the damage. The chances of survival are also influenced by the prompt provision of professional help. Chronic diseases such as diabetes, heart, lung, and kidney disease can also increase the likelihood of complications.