Shock is a life-threatening condition that occurs when the body is not getting enough blood flow. Lack of blood flow means that the cells and organs do not get enough oxygen and nutrients to function properly. Multiple organs can suffer damage as a result. Shock requires immediate medical treatment and can get worse very rapidly. As many 1 in 5 people who suffer shock will die from it.
The main types of shock include:
- Cardiogenic shock (due to heart problems)
- Hypovolemic shock (caused by too little blood volume)
- Anaphylactic shock (caused by allergic reaction)
- Septic shock (due to infections)
- Neurogenic shock (caused by damage to the nervous system)
Shock can be caused by any condition that reduces blood flow, including:
- Heart problems (such as heart attack or heart failure)
- Low blood volume (as with heavy bleeding or dehydration)
- Changes in blood vessels (as with infection or severe allergic reactions)
- Certain medications that significantly reduce heart function or blood pressure
Shock is often associated with heavy external or internal bleeding from a serious injury. Spinal injuries can also cause shock.
Toxic shock syndrome is an example of a type of shock from an infection.
A person in shock has extremely low blood pressure. Depending on the specific cause and type of shock, symptoms will include one or more of the following:
- Anxiety or agitation/restlessness
- Bluish lips and fingernails
- Chest pain
- Dizziness, lightheadedness, or faintness
- Pale, cool, clammy skin
- Low or no urine output
- Profuse sweating, moist skin
- Rapid but weak pulse
- Shallow breathing
Take the following steps if you think a person is in shock:
- Call 911 for immediate medical help.
- Check the person's airway, breathing, and circulation. If necessary, begin rescue breathing and CPR.
- Even if the person is able to breathe on his or her own, continue to check rate of breathing at least every 5 minutes until help arrives.
- If the person is conscious and does NOT have an injury to the head, leg, neck, or spine, place the person in the shock position. Lay the person on the back and elevate the legs about 12 inches. Do NOT elevate the head. If raising the legs will cause pain or potential harm, leave the person lying flat.
- Give appropriate first aid for any wounds, injuries, or illnesses.
- Keep the person warm and comfortable. Loosen tight clothing.
IF THE PERSON VOMITS OR DROOLS
- Turn the head to one side to prevent choking. Do this as long as you do not suspect an injury to the spine.
- If a spinal injury is suspected, "log roll" the person instead. To do this, keep the person's head, neck, and back in line, and roll the body and head as a unit.
- Do NOT give the person anything by mouth, including anything to eat or drink.
- Do NOT move the person with a known or suspected spinal injury.
- Do NOT wait for milder shock symptoms to worsen before calling for emergency medical help.
When to Contact a Medical Professional
Call 911 any time a person has symptoms of shock. Stay with the person and follow the first aid steps until medical help arrives.
Learn ways to prevent heart disease, falls, injuries, dehydration, and other causes of shock. If you have a known allergy (for example, to insect bites or stings), carry an epinephrine pen. Your doctor will teach you how and when to use it.
Jones AE, Kline JA. Shock. In: Marx JA, ,Hockberger RS, Walls RM, et al, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 8th ed. Philadelphia, Pa: Mosby Elsevier; 2013:chap 6.
Rivers EP. Approach to the patient in shock. In: Goldman L, Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 106.
Last reviewed 1/13/2014 by Jacob L. Heller, MD, MHA, Emergency Medicine, Virginia Mason Medical Center, Seattle, Washington. Also reviewed by David Zieve, MD, MHA, Bethanne Black, and the A.D.A.M. Editorial team.
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