Medical history (history of illness) represents an important component in the diagnosis of shock* . Family history What is the current health status of your family members? Social anamnesis Current medical history/systemic history (somatic and psychological complaints) [third-party history, if applicable]. What symptoms have you noticed? Are you experiencing rapid pulse, nausea, weakness, shortness of … Shock: Medical History
Respiratory System (J00-J99) Pulmonary hemorrhage, unspecified Tension pneumothorax – life-threatening condition characterized by collapse of the lung with development of excess pressure. Certain conditions originating in the perinatal period (P00-P96). Liver rupture as a birth injury Splenic rupture as birth injury Blood, blood-forming organs – immune system (D50-D90). Splenic rupture (rupture of the spleen) Skin … Shock: Or something else? Differential Diagnosis
The following are the major conditions or complications that may be contributed to by shock: Symptoms and abnormal clinical and laboratory findings not elsewhere classified (R00-R99). Multi-organ failure (MODS, Multi organ dysfunction syndrome; MOF: Multi organ failure) – simultaneous or sequential failure or severe functional impairment of various vital organ systems of the body as … Shock: Complications
A comprehensive clinical examination is the basis for selecting further diagnostic steps: Assessment of consciousness using the Glasgow Coma Scale (GCS). General physical examination – including blood pressure, pulse, body temperature, body weight, body height; furthermore: Inspection (viewing). Skin and mucous membranes (central cyanosis? (bluish discoloration of skin and central mucous membranes, e.g., tongue). Neck … Shock: Examination
1st order laboratory parameters – obligatory laboratory tests. Small blood count [Hb (hemoglobin) and hematocrit (Hk) are unsuitable for estimating current blood loss!] Inflammatory parameters – CRP (C-reactive protein) or PCT (procalcitonin). Urine status (rapid test for: pH, leukocytes, nitrite, protein, glucose, ketone, urobilinogen, bilirubin, blood), sediment, if necessary urine culture (pathogen detection and resistogram, … Shock: Lab Test
Therapy for shock depends on the cause. Basically, stabilization of circulatory conditions must be achieved. Notice: In the presence of anaphylactic shock, immediate i.m. Injection of epinephrine is indicated. If worsening occurs with volume therapy, think cardiogenic shock; timely catecholamine administration (eg, epinephrine or norepinephrine) should be given. Treatment recommendations for hypovolemic shock (cause: intravascular … Shock: Drug Therapy
Obligatory medical device diagnostics Continuous monitoring of vital signs: Blood pressure (RR): blood pressure measurement* [most important symptom of IkS – but not obligatory – hypotension (low blood pressure) < 90 mmHG systolic for at least 30 minutes, in conjunction with signs of organ diminished perfusion (organ diminished blood flow): cold extremities, oliguria (decreased urine … Shock: Diagnostic Tests
Secondary prevention of anaphylaxis Epinephrine auto-injector (AAI; epinephrine prefilled syringe); active ingredient: epinephrine hydrochloride (0.36 mg per 0.3 milliliter) = epinephrine (0.3 mg per 0.3 milliliter), i.m. (intramuscular, i.e., into the muscle; outer thigh). Adrenaline doses depending on body weight as well as clinical condition and taking into account individual risk factors: 15-30 kg body … Shock: Prevention
The following symptoms and complaints may indicate shock: Leading symptoms Hypotension (drop in blood pressure)? systolic < 100 mmHgNote: A child in shock may have normal blood pressure. Tachycardia? (heartbeat too fast: > 100 beats per minute). Associated symptoms Dyspnea (shortness of breath), dysphonia (hoarseness), airway obstruction (airway narrowing). Disturbances of consciousness Paleness Angina pectoris … Shock: Symptoms, Complaints, Signs
General measures Immediately make an emergency call! (Call number 112) Symptom-oriented positioning of the patient: Dyspnea (shortness of breath): elevate upper body (semi-sitting). Circulatory dysregulation (hypovolemia: reduction in circulating blood volume): flat positioning with legs elevated (Trendelenburg positioning). Clouding of consciousness: stable lateral position (to keep the airways free: fall back of the tongue and … Shock Treatment
