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Uploaded byDR.P.S SUDHAKAR
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SHOCK.HOMOEOPATHIC TREATMENT FOR BHMS pptx

SHOCK.HOMOEOPATHIC TREATMENT FOR BHMS

Health & Medicine◦
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SHOCK DR POTNURU SRINIVASA SUDHAKAR M.D.(HOMOEO) PROFESSOR AND HOD SURGERY
• Shock is a life-threatening condition which occurs when the circulatory system fails to deliver oxygen and nutrients to the body tissues and becomes unable to remove waste products from the body. • It is a descriptive term based on the symptoms and signs secondary to one or more of a wide range of problems. • If not recognized and corrected as early as possible, shock may rapidly progress to an irreversible state with subsequent multi-organ failure and death.
DEFINITION • Shock is defined as a pathological state causing inadequate oxygen delivery to the peripheral tissues and resulting in lactic acidosis, cellular hypoxia and disruption of normal metabolic condition.
CLASSIFICATION Shock is generally classified into three major categories: 1. Hypovolemic shock 2. Cardiogenic shock 3. Distributive shock Distributive shock is further subdivided into three subgroups: • a. Septic shock • b. Neurogenic shock • c. Anaphylactic shock
Hypovolemic shock Hypovolemic shock is present when marked reduction in oxygen delivery • results from diminished cardiac output secondary to inadequate vascular volume. • In general, it results from loss of fluid from circulation, either directly or indirectly. e.g. Hemorrhage • Loss of plasma due to burns • Loss of water and electrolytes in diarrhea • Third space loss (Internal fluid shift into inflammatory exudates in the peritoneum, such as in pancreatitis.)
Cardiogenic shock • Cardiogenic shock is present when there is severe reduction in oxygen delivery secondary to impaired cardiac function. • Usually it is due to myocardial infarction or pericardial tamponade. • (Cardiac tamponade is a life-threatening medical emergency where fluid rapidly accumulates in the sac surrounding the heart (pericardium).
Septic Shock • Septic Shock (vasogenic shock) develops as a result of the systemic effect of infection. • It is the result of a septicemia with endotoxin and exotoxin release by gram-negative and gram-positive bacteria. • Despite normal or increased cardiac output and oxygen delivery, cellular oxygen consumption is less than normal due to impaired extraction as a result of impaired metabolism.
Neurogenic shock • Neurogenic shock results primarily from the disruption of the sympathetic nervous system which may be due to pain or loss of sympathetic tone, as in spinal cord injuries.
PATHO PHYSIOLOGY OF SHOCK • Shock stimulates a physiologic response. • This circulatory response to hypotension is to conserve perfusion to the vital organs (heart and brain) at the expense of other tissues. • Progressive vasoconstriction of skin, splanchnic and renal vessels leads to renal corticalnecrosis and acute renal failure. • If not corrected in time, shock leads to organ failure and sets up a vicious circle with hypoxia and acidosis.
CLINICAL FEATURES The clinical presentation varies according to the cause. But in general patients with hypotension and reduced tissue perfusion presents with: 1. Tachycardia 2. Feeble pulse 3. Narrow pulse pressure 4. Cold extremities (except septic shock) 5. Sweating, anxiety 6. Breathlessness / Hyperventilation 7. Confusion leading to unconscious state
Clinical features of hypovolemic shock in adults with estimated volume loss. • Estimated blood loss 750-1500ml 1500ml-2000ml >2000 ml • Blood pressure Normal Reduced Severely Reduced Pulse rate >100/min >120/m >140/m very feeble • Capillary refill Slow Slow Undetectable . • Respiratory rate 20-30/m 30-40/m >35/m • Urinary flow rate (Normal: 30-60 ml/hr or 0.5- 1ml/kg/hr) • 20-30/hr 10-20/hr 0-10/hr • Mental state(CNS) Anxious confused Lethargic, comatose
MANAGEMENT OF SHOCK • Treatment is aimed at restoring oxygen delivery to the cells of vital organs as rapidly as possible. • The management depends on the cause and type of shock.
MANAGEMENT OF SHOCK General Management • Monitor the airway, breathing and circulation as first priority • Stop bleeding • Fluid resuscitation, preferably crystalloids • Head down position • Treat the cause • Transfusion of compatible blood if indicated • Oxygen and other supportive measures like inotropic agents • Monitoring of resuscitation effectiveness: e.g. determine hourly urine output, blood pressure and pulse rate
MANAGEMENT OF SHOCK Specific Management Hypovolemic Shock: The goal of treatment is to restore vascular volume. This is effected by: • General approach as above • Fluid and blood replacement • Oxygen support etc.
Management Septic Shock • Initial management as above • Appropriate antibiotics especially for gram- negative microorganisms Inotropic support such as adrenaline and dopamine • Surgical eradication of the infection focus
Cardiogenic shock • Initial management as above • Inotropes (Inotropes are medications that alter the force or energy of your heart’s muscular contractions.) • Treat the causes
Neurogenic shock • Initial management as above • Pain relief • Treat the causes, give supportive measures like inotropic support
COMPLICATIONS OF SHOCK The main complications of severe shock include: 1. Shock lung (ARDS) 2. Acute renal failure 3. Gastrointestinal ulceration 4. Disseminated intravascular clotting 5. Multiorgan failure 6. Death • Therefore, a patient in shock requires immediate emergency treatment. • Early diagnosis and immediate correction of shock prevents permanent organ damage and death.
HOMEOPATHIC THERAPEUTICS FOR SHOCK
• Homeopathic therapeutics for shock focus on addressing the immediate emotional or physical trauma using highly diluted remedies. • The remedy selected depends entirely on the root cause and the specific physical or psychological symptoms the patient exhibits.
• Aconitum napellus: The primary remedy for sudden fright, panic, or intense fear following a traumatic experience. [ • Arnica montana: Indicated for physical trauma, bruising, and shock where the person feels battered and insists they are "fine" and refuse assistance. • Ignatia amara: Often utilized for emotional shock, grief, or mood swings following sudden bad news or loss. • Hypericum perforatum: Known as the "Arnica of the nerves," this is used when shock is accompanied by shooting pains, tingling, or occurs after injuries to nerve- rich areas like the spine or fingertips. • Carbo vegetabilis: Indicated for states of deep collapse or fainting where the person feels cold, struggles to breathe, and wants to be fanned.
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