Tanzania Daily News (Dar es Salaam)

Tanzania: Dangerous Shock in Children

opinion

WE often hear people saying that someone is in shock or even extreme shock. Even children can be seized by shock. The situation can, sometimes, be life-threatening, especially if it is extreme shock.

This column, today, looks at how bad shock can be. Let me mention at the outset that shock can mean anything from a minor surprise to a fatal collapse of the body's blood circulation system. There is a distinction between psychological (or mental) shock and physiological (or blood circulatory) shock.

Psychological shock can occur after a physically or emotionally traumatic experience such coming face to face with a dangerous animal. Psychological shock can also arrest someone upon receiving bad news; say about the death of a parent. But the effect of psychological shock remains on your state of mind. Physiological shock is a dramatic reduction in blood flow that, if left untreated, can lead to collapse, coma and even death.

The most common symptoms of shock include a fast, weak pulse. Nearly everyone experiences these symptoms from time to time. However, more dangerous symptoms can include low blood pressure; feeling faint, weak or nauseous; feeling dizzy; feeling cold and having a clammy skin.

While these symptoms are described as near-fatal for adults, they can be fatal to children. Let me point out here that other symptoms may include rapid, shallow breathing and a twitching of lips or eyelids. Symptoms depend on the magnitude of the shock. Psychological or mental shock may be caused by hearing bad news such as the death of a close relative. In this case, its effect on children will depend on their age.

However, a young child involved in a traumatic event such as an accident may be equally devastated. Other shocking incidents include being trapped in a burning house or becoming a victim of a violent crime. Again, the magnitude of shock in children depends on age in the case of the violent crime, but, certainly, a raging fire will shock a child to the extreme.

While psychological shock is less likely to kill a child than physiological shock, its effects can persist for years in older children and cause immense disruption. Mild shocks can leave a child (or adult) feeling stunned for a while, unable to focus on anything else. After a while, though, the brain gets the event in perspective and normal life resumes.

However, especially if the shock is more profound, some people find it harder to return to normal, and may develop post-traumatic stress disorder. This tends to affect older children (and adults) in one of three ways: Intrusion - whereby the event is constantly replayed in the mind; avoidance - whereby the person feels numb, retreats from normal emotions and activities.

Some adults involved in this situation may use alcohol and take to stoning on narcotic drugs as a form of self-medication - an unfortunate undertaking, indeed. Psychological shock may also cause increased arousal. In this case (mainly in adults) the person is left angry, and prone to irritable behaviour. Now let us look at the causes of physiological (or blood circulatory) shock.

This type of shock can be caused by severe bleeding or by what is medically called pulmonary embolus (a blood clot in the lungs). In some rare cases physiological shock can be a result of severe vomiting, diarrhea, spinal injury or poisoning. The medical world also knows other types of physiological shock, with a different set of symptoms, for example, cardiogenic shock occurs when the heart is severely damaged.

This damage can be caused by a major heart attack. When cardogenic shock ensues the heart fails to pump blood around the body properly, causing very low blood pressure. This development can be difficult to treat, but drugs may be given to enhance the strength of heart beats.

This may be enough to bring someone through the worst until the heart can mend itself, but cardiogenic shock is still fatal in eight out of ten cases and can be frightening to parents if it occurs in a child. New treatments to restore blood flow to the heart muscle improving survival rates.

Septic shock occurs when an overwhelming bacterial infection causes blood pressure to drop. It's fatal in more than 50 per cent of cases especially in children. Although it is caused by bacterial infection, treating septic shock with antibiotics is not simple at all. The main reason is that bacteria release massive amounts of toxin when they are killed off, which initially makes the shock worse. Septic shock must always be treated in hospital where the correct drugs and fluid support can be given.

One type of septic shock is toxic shock syndrome - a rare but severe illness caused by certain strains of the bacteria known in the medical parlance as staphylococcus aureus. Anaphylactic shock is a severe allergic reaction. Common triggers include bee and wasp stings, nuts, shellfish, eggs, latex and certain medications, including penicillin.

Symptoms include burning and swelling of the lips and tongue, difficulty breathing (like in an asthma attack), blistered skin, sneezing, watery eyes, nausea and anxiety. Anaphylaxis requires urgent treatment in hospital. Children at risk should always be rushed to hospital. If you are close to a child who goes into shock, prompt treatment can make all the difference.

Lay the child flat and raise his legs by at least 25cm to help restore blood pressure. If he is conscious but having trouble breathing, it is better to sit him up. Loosen tight clothing and keep him warm with layers of blankets. Do not give him anything to eat or drink because of the risk of vomiting. Call an ambulance or other help as soon as possible.

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