Total body shock
Sepsis is a life-threatening illness caused by your body’s response to an infection. Your immune system protects you from many illnesses and infections, but it’s also possible for it to go into overdrive in response to an infection.
Sepsis develops when the chemicals the immune system releases into the bloodstream to fight an infection cause inflammation throughout the entire body instead. Severe cases of sepsis can lead to septic shock, which is a medical emergency.
There are more than 1.5 million cases of sepsis each year, according to the Centers for Disease Control and Prevention (CDC) . This type of infection kills more than 250,000 Americans a year.
There are three stages of sepsis: sepsis, severe sepsis, and septic shock. Sepsis can happen while you’re still in the hospital recovering from a procedure, but this isn’t always the case. It’s important to seek immediate medical attention if you have any of the below symptoms. The earlier you seek treatment, the greater your chances of survival.
Symptoms of sepsis include:
- a fever above 101ºF (38ºC) or a temperature below 96.8ºF (36ºC)
- heart rate higher than 90 beats per minute
- breathing rate higher than 20 breaths per minute
- probable or confirmed infection
You must have two of these symptoms before a doctor can diagnose sepsis.
Severe sepsis occurs when there’s organ failure. You must have one or more of the following signs to be diagnosed with severe sepsis:
Symptoms of septic shock include the symptoms of severe sepsis, plus a very low blood pressure.
Although sepsis is potentially life-threatening, the illness ranges from mild to severe. There’s a higher rate of recovery in mild cases. Septic shock has close to a 50 percent mortality rate, according to the Mayo Clinic. Having a case of severe sepsis increases your risk of a future infection. Severe sepsis or septic shock can also cause complications. Small blood clots can form throughout your body. These clots block the flow of blood and oxygen to vital organs and other parts of your body. This increases the risk of organ failure and tissue death (gangrene).
Any infection can trigger sepsis, but the following types of infections are more likely to cause sepsis:
According to the National Institute of General Medical Sciences , the number of sepsis cases in the United States increases every year. Possible reasons for the increase include:
- an aging population, because sepsis is more common in seniors
- an increase in antibiotic resistance, which happens when an antibiotic loses its ability to resist or kill bacteria
- an increase in the number of people with illnesses that weaken their immune systems
Although some people have a higher risk of infection, anyone can get sepsis. People who are at risk include:
- young children and seniors
- people with weaker immune systems, such as those with HIV or those in chemotherapy treatment for cancer
- people being treated in an intensive care unit (ICU)
- people exposed to invasive devices, such as intravenous catheters or breathing tubes
Neonatal sepsis is when your baby gets a blood infection within the first month of life. Neonatal sepsis is classified based on the timing of the infection, according to whether the infection was contracted during the birth process (early onset) or after birth (late onset). This helps the doctor decide what kind of treatment to administer. Low birth weight and premature babies are more susceptible to late onset sepsis because their immune systems are immature. While symptoms can be subtle and nonspecific, some signs include:
- not breastfeeding well
- low body temperature
- apnea (temporary stopping of breathing)
- pale color
- poor skin circulation with cool extremities
- abdominal swelling
- yellowing of the skin and whites of the eyes (jaundice)
- problems feeding
Neonatal sepsis is still a leading cause of infant death, but with early diagnosis and treatment, the baby will recover completely and have no other problems. With maternal universal screening and proper neonatal testing, the risk of neonatal sepsis has decreased significantly.
Since our immune system weakens as we age, seniors can be at risk for sepsis. In one 2006 studyTrusted Source , people over the age of 65 made up nearly 70 percent of sepsis cases. In addition, chronic illness, such as diabetes, kidney disease, cancer, high blood pressure, and HIV, are commonly found with those who have sepsis. The most common types of infections to cause sepsis in seniors are respiratory like pneumonia or genitourinary like a urinary tract infection. Other infections can come with infected skin due to pressure sores or skin tearing. While these infections might not be noticed for a while, confusion or disorientation is a common symptom to look for when identifying an infection in seniors.
Sepsis isn’t contagious. However, the pathogens that caused the original infection that lead to sepsis can be contagious. Sepsis spreads within a person’s body from the original source of infection to other organs through the bloodstream.
If you have symptoms of sepsis, your doctor will order tests to make a diagnosis and determine the severity of your infection. One of the first tests is a blood test. Your blood is checked for complications like:
- clotting problems
- abnormal liver or kidney function
- decreased amount of oxygen
- an imbalance in minerals called electrolytes that affect the amount of water in your body as well as the acidity of your blood
Depending on your symptoms and the results of your blood test, your doctor may order other tests, including:
- a urine test (to check for bacteria in your urine)
- a wound secretion test (to check an open wound for an infection)
- a mucus secretion test (to identify germs responsible for an infection)
If your doctor can’t determine the source of an infection using the above tests, they may order an internal view of your body using one of the following:
- to view the lungs to view possible infections in the appendix, pancreas, or bowel area to view infections in the gallbladder or ovaries
- MRI scans, which can identify soft tissue infections
There are two tools, or sets of criteria, doctors use to determine the severity of your condition. One is the systemic inflammatory response syndrome (SIRS). SIRS is defined when you meet two or more of the following criteria:
- fever of more than 100.4°F (38°C) or less than 96.8°F (36°C)
- heart rate of more than 90 beats per minute
- respiratory rate of more than 20 breaths per minute or arterial carbon dioxide tension (PaCO2) of less than 32 mm Hg
- abnormal white blood cell count
Another tool is the quick sequential organ failure assessment (qSOFA). It uses the results of three criteria:
- low blood pressure reading
- high respiratory rate (greater than 22 breaths per minute)
- Glasgow coma scale score of less than 15 (This scale is used to determine your level of consciousness.)
A positive qSOFA is determined if two or more of the above measurements are abnormal. Some physicians prefer using qSOFA because unlike the SIRS criteria, qSOFA doesn’t require laboratory tests. The results of either of these assessments will help your doctor determine care.
Sepsis can quickly progress to septic shock and death if it’s left untreated. Doctors use a number of medications to treat sepsis, including:
- antibiotics via IV to fight infection
- vasoactive medications to increase blood pressure
- insulin to stabilize blood sugar
- corticosteroids to reduce inflammation
Severe sepsis may also require large amounts of IV fluids and a respirator for breathing. Dialysis might be necessary if the kidneys are affected. Kidneys help filter harmful wastes, salt, and excess water from the blood. In dialysis, a machine performs these functions. In some cases, surgery may be needed to remove the source of an infection. This includes draining a pus-filled abscess or removing infected tissue.
Your recovery from sepsis depends on the severity of your condition and any preexisting conditions you might have. Many people who survive will recover completely. However, others will report lasting effects. The UK Sepsis Trust says it can take up to 18 months before survivors start to feel like their normal self. The Sepsis Alliance says that around 50 percent of sepsis survivors deal with post-sepsis syndrome (PSS). The alliance says this condition includes long-term effects such as:
- damaged organs
- disabling muscle and joint pains
- poor concentration
- lowered cognitive functioning
- lowered self-esteem
Severe cases of sepsis can lead to death.
Taking steps to prevent the spread of infection can reduce your risk of developing sepsis. These include:
- Staying up to date on your vaccinations. Get vaccinated for the flu, pneumonia, and other infections.
- Practicing good hygiene. This means practicing proper wound care, handwashing, and bathing regularly.
- Getting immediate care if you develop signs of infection. Every minute counts when it comes to sepsis treatment. The sooner you get treatment, the better the outcome.
It’s important to remember that sepsis is a medical emergency. Every minute and hour counts, especially since the infection can spread quickly. There’s no one symptom of sepsis, but rather it has a combination of symptoms. Get immediate medical attention if you suspect that you have sepsis, especially if you have a known infection.
From Head to Toe
We’re going to start at the top which is our shoulders and work our way down until we finish with the calves.
We’re going to work each area in two different ways for two different purposes which will be explained in their sections.
Shoulders: Lateral Raise & Arnold Press
The shoulders can help you appear wider and if they are properly developed then they can give your physique a powerful look. For the width, the obvious choice is lateral raises. You can do them standing or seated.
As for the power, no name in bodybuilding is more powerful than Arnold so Arnold Presses make sense here. The twisting motion can allow you to hit all three heads of the delt so nothing is neglected.
Back: Neutral Grip Pulldown & T-Bar Row
There are two movements that you need to develop a complete upper back. They are pulling up or down and rowing. For the pulling portion, neutral grip lat pulldowns are great because the neutral grip can help you blast your lats while keeping bicep and shoulder involvement to a minimum.
When it comes to rows, the T-bar version is a great one that you can use. It’s a simple lift you can go heavy on but thanks to the fixed pattern can be a controlled one.
Chest: Incline Dumbbell Press & Cable Crossover
Much like the back, the chest is trained in two different ways. You can press or you can fly. Obviously for this program we’re going to do both.
Incline dumbbell presses allow you to work each side independently. This move is also a free weight, compound lift so you can build some serious muscle with it.
Cable crossovers will help you isolate the chest and really target each pec that’s working. Focus on getting good contractions with each rep to pump some blood into the chest.
Biceps: Barbell Curl & Hammer Curl
Before we go any further down the body we should knock out some arm work. For biceps we’re going to keep it as simple as possible with barbell curls and hammer dumbbell curls.
The barbell curl forces you to lift with your hands supinated so you can maximize that peak. Hammers are great because you can target your brachialis as well as your forearms. These two moves are as basic as they come but they’re also effective.
Triceps: Overhead Extensions & Rope Pushdowns
For the back of the arms we’re going to go in opposite directions. First we’re going to go up with two arm overhead extensions. You can use a heavy dumbbell or a barbell, whichever you’re more comfortable with.
Then we’re going to push down, as in rope pushdowns. The rope will allow you to separate the ends so you can put an extra squeeze on the long head of the muscles.
Core: Crunches & Hyperextensions
Notice I didn’t say abs. For our midsection area we’re going to do one movement for the abs and one for the lower back. For the abdominals you can do the basic crunch. Squeeze your abs hard and force your air out to really contract them before going back down.
Next, head over to the low back bench for hyperextensions. This is a simple movement but don’t fly through the reps. You can still get hurt easily if you’re not careful. If you feel it’s necessary, hold on to a weight for extra resistance.
Quadriceps: Leg Press & Leg Extension
I know, squat is king. But for this plan we’re going to stick to machines. So you got the leg press and leg extension. For the leg press, pay attention to your range of motion. Moving the sled four or five inches isn’t going to do anything productive and it will increase wear and tear on your knees.
When you start your leg extensions, make sure you squeeze the quads for a good contraction at the top. Hold it for a count of 1 before lowering the weight back down.
Hamstrings: Stiff Legged Deadlift & Leg Curl
Hamstrings are the lower body muscle that never seems to get enough love. People will throw one in after three or four quad movements. So for this program, make sure you really focus on the back of the legs.
Start with stiff-legged deadlifts. Instead of doing them on the floor, place a plate or step where you would normally stand so you can get extra range of motion. This longer stretch will burn but you will see the rewards for yourself soon enough.
Next, perform leg curls. The version you do can be up to you because I know not all gyms have all three (lying, seated, standing). Regardless of the version you choose, make sure you perform negatives. Since you can’t watch your hamstrings work, these negatives will help you feel them working.
Calves: Standing & Seated Calf Raises
There are two portions of the calf muscle. The gastrocnemius is the visible part of the calf you see when you flex. You need to do a standing calf raise to target this area.
The soleus resides under the gastrocnemius and is active when the legs are bent so seated calf raises are going to serve your needs here.
What to know about hypovolemic shock
Hypovolemic shock typically refers to a severe drop in blood volume that leads to further complications in a person’s health.
The heart cannot pump blood around the body unless a certain volume of blood is present. Blood volume describes the total amount of blood in the body. If a person’s blood volume drops significantly, then a person can go into hypovolemic shock.
Many health problems can lead to hypovolemic shock. A doctor will diagnose a patient with the issue once an individual loses 20% or more of their blood volume. Hypovolemic shock is a medical emergency that is difficult to diagnose and treat. It can result in organ failure.
In a study, more than 82% of patients who died from hypovolemic shock died within the first 24 hours.
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There are approximately three stages of hypovolemic shock based on the level of blood volume loss. All the stages require fast treatment. The earlier doctors can recognize the stage of shock a person is in, the faster they can give the patient the appropriate treatment.
During the earliest stage of hypovolemic shock, a person loses less than 20% of their blood volume. This stage can be difficult to diagnose because blood pressure and breathing will still be normal.
The most noticeable symptom at this stage is skin that appears pale. The person may also experience sudden anxiety.
In the second stage, the body loses 20-40% of blood. The individual may experience increased heart and breathing rates.
Blood pressure may still be within normal range. However, the diastolic pressure, or bottom number, of their blood pressure may be high. The person may begin sweating, as well as feeling more anxious and restless.
By stage 3, a person with hypovolemic shock will have lost more than 40% of their blood.
The systolic pressure, or top number, of their blood pressure, will be 100 millimeters of mercury (mm Hg) or lower. Their heart rate will increase to over 120 beats per minute (bpm). They will also have a rapid breathing rate of more than 30 breaths per minute.
They will begin to experience mental distress, including anxiety and agitation. Their skin will be pale and cold, and they will begin sweating. They will have a weak pulse but an extremely rapid heart rate.
Breathing will become be very fast and difficult. Systolic blood pressure will be under 70 mm/Hg. They may experience the following symptoms:
- drifting in and out of consciousness
- sweating heavily
- feeling cool to the touch
- looking extremely pale
A major cause of hypovolemic shock can be acute blood loss. The term hemorrhagic shock refers specifically to this type of hypovolemic shock. This can occur as a result of an acute tissue injury or because of conditions like internal bleeding or illness.
But, hypovolemic shock can also refer to any major loss of bodily fluid that also results in significant blood loss. Blood plasma is the liquid part of blood that holds red blood cells, white blood cells, and blood platelets. Water makes up 92% of plasma. If a person loses a significant volume of fluid, the plasma part of blood will deplete too.
For this reason, many conditions that are not acute blood loss can lead to a critical reduction in blood volume. Severe burns, persistent diarrhea, vomiting, and even excessive sweating could all be potential causes of hypovolemic shock.
Doctors can identify hypovolemic shock more easily when they can see significant blood loss from an external wound. However, hypovolemic shock often develops as a complication of an underlying medical condition. Internal bleeding may not be obvious from observation and is often hard to control without surgery.
Medical professionals and first responders are trained to recognize the signs of blood loss. However, people should educate themselves on its signs so that they can get help for themselves and others as quickly as possible.
Hypovolemic shock usually occurs as a result of either an illness, injury, or other medical condition. As a result, doctors may find it hard to predetermine specific risk factors. Any risk factors would be the risk of getting a condition that can cause the shock, such as the risk of being severely injured in a car crash or having an aneurysm rupture.
When a person is dehydrated, they lose a significant amount of water volume. People who are dehydrated can become hypovolemic if they are also losing salt, which can lead to a loss in blood volume.
For this reason, people who are dehydrated, or at risk of becoming dehydrated, should continue to drink fluids, especially if their illness is causing them to experience vomiting or diarrhea. These can lead to further loss of fluids.
A person may not be able to prevent the injuries or illnesses that cause hypovolemic shock. However, a person may be able to prevent further complications by rehydrating.
The easiest way for a medical professional to diagnose hypovolemic shock is through observation and examination. A physical exam will show whether the person has low blood pressure, increased heart and breathing rates, and a low body temperature.
Doctors can use blood tests to help support this diagnosis. A blood chemistry test can give some additional clues about the level of salt and electrolytes in the body as well as how the kidneys and liver are functioning. A complete blood count (CBC) can tell how much blood a person has lost.
The following tests or devices can help determine the underlying cause of the hypovolemia or locate a source of internal bleeding:
- a CT scan can give a view of the organs in the body
- an echocardiogram can assess how well the heart fills up with and squeezes blood
- an endoscopy can help find a bleeding source in the gastrointestinal tract
Treating hypovolemic shock means treating the underlying medical cause. Physicians first will try to stop fluid loss and stabilize blood volume levels before more complications develop.
Doctors usually replace lost blood volume with intravenous (IV) fluids called crystalloids. These are liquids with a thin consistency, such as a saline solution. The doctor may also use thicker solutions called colloids.
In the most severe cases, the remaining blood becomes diluted. This can result in low levels of platelets and other blood components that help form clots that stop bleeding. The medical team will replace these components when necessary, especially if the person is still bleeding, through plasma or red blood cell (RBC) transfusions.
After the shock is under control and the blood volume stabilizes, the doctor can treat the underlying illness or injury.
Hypovolemic shock is a life-threatening emergency. A person’s outlook depends heavily on which complications develop while a person is in shock. This can include damage to the kidneys or brain. It is critical that an emergency doctor increases the person’s blood volume quickly to restore blood supply to all organs.
The amount of time it takes to increase the blood volume can depend on:
- the stage of shock
- the rate of blood loss
- the extent of blood loss
- any underlying medical conditions, such as heart disease or taking blood thinners
Hypovolemic shock and older adults
Older adults are particularly at risk of getting hypovolemic shock because they can be more susceptible to dehydration, which can trigger hypovolemia. They also do not tolerate having a low blood volume well.
The risk of complications increases with age, especially if other conditions have already caused organ damage such as kidney failure or a heart attack.
It is especially important that older adults receive prompt treatment as soon as they, or individuals near them, recognize any signs of hypovolemic shock.
Hypovolemic shock is a medical emergency in which blood volume drops to a dangerous level. It occurs when the body loses excessive amounts of water and salt. The condition has four stages. By the fourth stage, a person’s condition becomes critical.
Treatment for this type of shock involves replacing fluids in the body, usually with a saline solution. However, treatment is difficult and the condition usually carries a high risk of death. The best way to stabilize the condition is to spot symptoms as early as possible and to seek prompt medical treatment.
How to: Begin in full pushup position, palms under shoulders (a). Lift left leg and place left knee on the floor near left shoulder, gently guiding left foot toward right wrist (b). Lower down to forearms and bring right leg down with top of foot resting on floor (c). Bring chest down to floor and arms in front of you, hands out in front, fingers wide (d). Hold for 30 seconds.
Get your yoga and strength training done all at once with this strength training yoga routine:
What causes body jolts and zaps anxiety symptoms?
This sensation is a common symptom of persistently elevated stress, including that from behaving overly anxiously.
As this symptom relates to anxiety, there are two primary causes:
1. Anti-anxiety and antidepressant medication related
This symptom can be caused by anxiety medication, whether when just starting a medication, while on one, when adjusting dosage, when adding to or subtracting another medication, or when withdrawing from a medication. Since anxiety medications affect how the nervous system (which includes the brain) functions, medication’s influence or elimination can cause the nervous system to act erratically.
It’s common to experience “body jolts” in connection with these types of medications. You should discuss this symptom with your doctor or pharmacist if you think it is being caused by the medication you are taking.
2. The adverse effects of stress-response hyperstimulation
Behaving anxiously activates the body’s stress response. Stress responses stress the body, and in particular, the body’s nervous system, which includes the brain. A body that becomes overly stressed can exhibit symptoms. Experiencing sudden body jolts, zaps, tremors, and shakes is an example of how the body can react when it becomes overly stressed.
If you are interested in a more detailed explanation, we explain this symptom in great detail in our Symptoms chapter in the Recovery Support area of our website.
Nevertheless, even though the body jolts and zaps anxiety symptoms can be startling because they generally occur out of the blue, they aren’t harmful. They are merely the consequences of an overly stressed body (stress-response hyperstimulation).
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Medical shock is a life-threatening emergency. Effective first aid and prompt medical attention can save a person’s life. Be aware of the first aid management which includes:
- Lay the Person Down, if Possible: Elevate the person’s feet about 12 inches unless head, neck, or back is injured or you suspect broken hip or leg bones; Do not raise the person’s head; Turn the person on side if they are vomiting or bleeding from the mouth.
- Begin CPR, if Necessary: If the person is not breathing or breathing seems dangerously weak, or a child, start CPR for children, for an adult, start adult CPR; Continue CPR until help arrives or the person wakes up.
- Treat Obvious Injuries
- Keep Person Warm and Comfortable: Loosen restrictive clothing; Cover with a coat or blanket; Keep the person still. Do not move the person unless there is danger; Reassure the person; Do not give anything to eat or drink.
- Follow Up: At the hospital, the person will be given oxygen and intravenous fluids; Blood test, urine tests, heart test and xrays and/or CT scans may be done; Other treatment will depend on the cause of shock. 
The treatment of any form of dehydration depends not only on restoring the depleted water but also on reestablishing normal levels of body electrolytes and limiting the production of nitrogenous waste products. Before any of these therapeutic measures can be applied, however, the initiating cause must be removed. The sailor or the desert traveler must be rescued, the vomiting infant must be cured, or the underlying disease must be treated. Then, after accurate biochemical determinations of the levels of various electrolytes and other blood components have been made and the plasma volume has been measured, the physician may give measured quantities of the appropriate mixtures of salt and water. Given the right amounts of salt and water, the human body will gradually restore the normal relationships between the cells, the extracellular fluid, and the plasma volume. That done, the complicated functions of the kidney will clear the circulating blood of the retained waste products, and the body will have restored its own normal balance.