IV. Read and translate the text: shock

The clinical syndrome termed shock is a complex situation often associated with severe injuries.

The typical signs of shock are low blood pressure, a rapid heartbeat and signs of poor end-organ perfusion or "decompensation" (such as low urine output, confusion or loss of consciousness). Medical shock is a life-threatening medical emergency and one of the most common causes of death. Shock can have a variety of effects, all with similar outcomes, but all relate to a problem with the body's circulatory system. For example, shock may lead to hypoxemia (a lack of oxygen in arterial blood) or cardiac arrest (the heart stopping).

Signs and symptoms

The presentation of shock is variable with some people having only minimal symptoms such as confusion and weakness. While the general signs for all types of shock are low blood pressure, decreased urine output, and confusion may not always be present.

There are four stages of shock: initial, compensatory, progressive, refractory; and septic shock. As it is a complex and continuous condition there is no sudden transition from one stage to the next. At a cellular level shock is oxygen demand greater than oxygen supply.

Differential diagnosis

Shock is a common end point of many medical conditions. It has been divided into four main types: hypovolemic, distributive, cardiogenic and obstructive.

Management

The best evidence exists for the treatment of septic shock in adults. Management may include securing the airway via intubation to decrease the work of breathing, intravenous fluids and a passive leg raise, and blood transfusions. It is important to keep the person warm as well as adequately manage pain and anxiety as these can increase oxygen consumption.

Epidemiology

Hemorrhagic shock occurs in about 1-2% of trauma cases.

Prognosis

The prognosis of shock depends on the underlying cause and the nature and extent of concurrent problems. Hypovolemic, anaphylactic and neurogenic shocks are treatable and respond well to medical therapy. Septic shock however, is a grave condition with a mortality rate between 30% and 50%. The prognosis of cardiogenic shock is even worse.

VI. Answer the following questions to the text:

1. What is shock?

2. When does the state of shock occur?

3. What are the typical signs of shock?

4. What can shock lead to?

5. How many stages of shock do we distinguish?

6. What do you know about four types of shock?

7. What may management of shock include?

8. What is the prognosis of different types of shock?

Translate word-combinations from English into Russian:

Сильный ушиб, потеря сознания, неотложное состояние опасное для жизни, проявление болезни, помрачение сознания и слабость, сложное и продолжительное состояние, потребность и обеспечение кислородом, пассивное поднятие ног, хорошо реагировать на медицинское лечение, смертность.

IX. A). Read and translate the following text. Describe the patient in shock.

b). Make up 5 questions to the text in a written form.

The following is the description of shock made by the famous surgeon N. Pirogov: “You see a wounded soldier without an arm or leg lying still at the dressing station: he does not cry or moan or complain, but is indifferent to everything and does not ask for anything: his eyes are immovable and he gazes into the distance, his body being cold and his face pale as those of a corpse. His pulse is like a tread, barely noticeable. His wound and skin are almost completely insensitive, the patient displaying a sign of sensation only by contraction of the facial muscles. Sometimes this state passes off within a few hours, and sometimes it persists unchanged until death.”