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What Are the Stages of Shock?

Stage 4 of shock is the refractory stage, which can lead to death.
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  • Written By: Hillary Flynn
  • Edited By: Bronwyn Harris
  • Last Modified Date: 22 July 2014
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The definition of the word "shock" is much different in the medical community than what the general public usually thinks when hearing the term. Typically, people use the word to describe a surprisingly intense emotional or psychological reaction to information or an occurrence. In the medical community, the word shock refers to a physical imbalance between the oxygen needed and the oxygen actually supplied to cells in addition to a lack of nutrients being delivered. This can cause cellular dysfunction, organ failure, and can eventually lead to death. There are four stages of shock:

Stage 1: Initial Stage of Shock

The first of the stages of shock is reversible, but there aren't any signs to indicate shock at this stage. Cells begin to change due to issues with perfusion and oxygenation. Perfusion is the method used by arteries to deliver blood to capillary beds in body tissues. Without this nutritive blood and an adequate oxygen supply, the cells switch to anaerobic metabolism, producing pyruvic and lactic acid.

Stage 2: Compensatory Stage of Shock

During the compensatory stage of shock, the body tries to reverse the results of the initial stage. Physiological, neural, hormonal, and biochemical reactions are employed to correct the imbalances. Hyperventilation is one such mechanism. This causes an increased rate of breathing which, in turn, may help to get more oxygen flowing to the cells and neutralize the newly acidic conditions.

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Another mechanism is the catecholamine response. Hypotension, or low blood pressure, due to the reduced volume of blood flow triggers this response. Catecholamines are hormones released by the adrenal glands. These hormones increase heart rate and attempt to increase blood pressure.

A third mechanism used in the compensatory stage of shock is the renin-angiotensin response. During this response, a hormone called vasopressin is released into the bloodstream. Vasopressin helps to retain fluid and triggers vasoconstriction.

Stage 3: Progressive Stage of Shock

If the stages of shock progress to the third stage before the initial cause is corrected, damages become more severe and can be irreversible. Cellular function continues to deteriorate, anaerobic metabolism leads to increased metabolic acidosis, and the compensatory mechanisms can no longer maintain the balance required to protect the organs.

Stage 4: Refractory Stage of Shock

The stages of shock will eventually lead to the refractory stage if the cause of shock cannot be fixed. At this stage, the organs completely fail and lead to death. It is important to understand the stages of shock in order to recognize and prevent the progression to this final stage.

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Discuss this Article

anon156316
Post 4

Can you briefly describe the stages of psychological shock?

CarrotIsland
Post 3

@googie98: To break it down; “hypo” means low and “volemic” means volume. So, simply put, when our bodies loses its essential fluids, it cannot function.

We must have enough water and red blood cells in our blood for the heart to be able to push the fluid within the blood vessels. When we get dehydrated, we may not have enough red blood cells and the total volume of fluid is decreased, which causes the pressure within the system to fall. If there is not enough blood in the system for the heart to pump, it will try to speed up to maintain a steady output.

Different causes of hypovolemic shock include: severe diarrhea or vomiting and even heat stroke or heat exhaustion (because of extreme sweating). Diabetic ketoacidosis can also lead to hypovolemic shock because it can cause a significant amount of water loss because of elevated blood sugar.

googie98
Post 2

@medicchristy: What exactly is hypovolemic shock?

medicchristy
Post 1

There are also several different types of shock that our bodies can go through. They are: Hypovolemic shock, Hemorrhagic shock, Cardiogenic Shock, Neurogenic shock, and Hypo- or Hyper-glycemic shock.

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