There are three types of shock, caused by several different initiators. It's important to monitor blood pressure changes and a few other symptoms to determine the type and cause of shock and proper intervention options. All forms of shock need proper treatment and transport to an emergency room immediately.
Blood Pressure
Blood pressure is one of the major vitals of the body, the pressure created by the beating of the heart. Two pressures are always obtained when taking vitals. One is called the systolic, or the pressure of the blood when the heart is beating; the other is the diastolic, or the pressure of the arteries when the heart is relaxed between beats. Normal blood pressure in adults is less than 120/80mm Hg. Normal blood pressure for adolescents has a much larger range based on size, age and sex. In general, though, the pressures range from 80mm Hg to120mm Hg for systolic and 40mm Hg to 90mm Hg for diastolic. If shock is suspected, blood pressure must be taken every five minutes to determine what kind of shock the person is in and whether the shock is progressing or resolving. All of causes of shock go through the stages of compensated, decompensated and irreversible shock.
Compensated Shock
In compensated shock, blood pressure is normal or low normal. Other symptoms of shock must be observed to even have an idea that shock is happening at this point. This stage of shock is called compensated because the body is still able to compensate for blood loss or slower blood flow. This is done by shunting blood away from the extremities and into the core of the body. Delivering treatment with fluid and blood replacement at this time can help blood pressure remain stabilized and reverse the process of shock altogether.
Decompensated Shock
This is the stage at which the body can no longer compensate for loss of fluid, blood or altered signals from the brain. When these things happen, blood pressure begins to drop rapidly. This is why it's important to continue to monitor blood pressure changes every five minutes. The American Academy of Orthopedic Surgeons defines decompensated shock as a systolic blood pressure less than 90mm Hg. Healthy young women can have systolic numbers lower than 90mm Hg and not be in shock, so if there are no other outward signs or situations to indicate that anything is wrong with a female, don't just assume she's in shock. If treatment for shock has not started by the time the blood pressure has dropped, it will likely progress to irreversible shock.
Irreversable Shock
At this point, the heart makes a last-ditch effort to beat rapidly to pump fluid through the body. Even thought the heart is pumping hard, it's difficult to obtain a blood pressure. If a blood pressure can be obtained, it will be less than 60mm Hg systolic. Death is imminent at this point.
References
- "Emergency Care and Transportation of Sick and Injured Ninth Edition;" American Academy of Orthopedic Surgeons; 2005.
- NIH
- St Petersburg College
