Symptoms and Signs of Shock

Medical Author:
Medically Reviewed on 11/23/2021

Doctor's Notes on Shock

Shock is defined as abnormal metabolism (usually not enough oxygen) at the cellular level. This abnormal metabolism causes organs to begin to lose their ability to compensate. In general, when shock occurs, breathing rate gets faster and the heart beats faster also. As the organs begin to decompensate, blood pressure frequently begins to drop. As body cells fail to get enough oxygen other signs and symptoms may develop, such as confusion, chest pain, diarrhea, acute renal failure, and the skin becomes clammy and pale. Then loss of consciousness, coma, and/or death occurs if the underlying problem is not treated.

The causes of shock are many. However, the most basic underlying problem is that cells in one or more organs are deprived of oxygen so they cannot make the organ function normally. Some examples of underlying problems that may decrease oxygen delivery are as follows: large blood loss from trauma, GI bleeding or dehydration, the amount of oxygen in the air is decreased (high altitudes, carbon monoxide poisoning), lung injury (pneumonia, congestive heart failure, pulmonary edema, lung trauma), and heart problems such as heart attack, arrhythmia, pericarditis, and inflammation of heart muscle. Any underlying cause of bleeding problems can cause shock, including cancers, leukemia, or bleeding from the uterus during childbirth.

What Are the Treatments for Shock?

For this emergency, have someone call 911, and immediately do the following:

  • Begin CPR if the patient is not breathing, moving, or coughing.
  • If bleeding, control it with direct pressure using a sheet or towel.
  • If allergy is suspected, use an epinephrine autoinjector.
  • If possible, without further injury, elevate the feet about 12 inches.
  • Keep the patient still and try not to move the person.
  • Loosen any restrictive clothing or other items like belts and watches.
  • Cover with a blanket to prevent chilling.
  • Turn a patient who is vomiting or bleeding from the mouth onto their side.
  • Do not let the patient eat or drink.
  • Get the patient to an ER, preferably by an ambulance.

Consider treating any underlying causes, if possible.

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Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.