Types and Causes of Medical Shock

Anaphylactic shock pic
Anaphylactic shock
Image: webmd.com

Dr. Zachary Lutsky serves the public as a board-certified emergency room physician. Most recently in practice at Santa Clara Valley Medical Center, Dr. Zachary Lutsky applied an in-depth knowledge of shock and its treatment.

Shock is a life-threatening medical condition in which the blood pressure drops so low that vital organs do not receive sufficient oxygen. There are a number of types of shock, each of which has a different root cause.

Anaphylactic shock, for example, results from an allergic reaction. It occurs when exposure to an allergen activates an excessive immune response that causes a tightening of the airways, a change in heart rhythm, and swelling of the facial tissues.

Cardiogenic shock occurs due to severe heart damage, most often from a heart attack or other serious cardiac condition. This can cause a number of structural or functional abnormalities, such as paralysis or tears in the heart muscle, and prevent the heart from pumping enough blood.

Hypovolemic shock follows a similar process in that excessive blood or fluid loss leaves the heart incapable of pumping properly. Septic shock, on the other hand, develops due to an inflammatory response associated with the toxins of a systemic infection, while neurogenic shock arises as a result of injury or trauma to the spinal cord.

Any case of shock constitutes a medical emergency. Without the delivery of fluids to raise blood pressure and treatment targeted at the cause of shock, the patient can go into organ failure and die.


Weight Loss Surgery May Reduce the Risk of Stroke and Heart Attack

Weight Loss Surgery pic
Weight Loss Surgery
Image: webmd.com

An emergency medicine physician practicing in Southern California, Zachary Lutsky, MD, has several years of experience working in trauma centers, including Cedars-Sinai Medical Center, Santa Clara Medical center and Harbor UCLA. At such facilities, Dr. Zachary Lutsky has diagnosed and treated patients experiencing strokes and heart attacks.

According to recent research, obesity surgery for patients with type-2 diabetes dramatically reduces their risk of strokes and heart attacks. In fact, weight loss surgery is linked to a 40 percent decrease in the chance of having a stroke or heart attack in the first five years following the procedure.

Researchers discovered this link by tracking roughly 20,000 patients who were severely obese and had type-2 diabetes. These patients were found in records from four major health care systems in the United States: Kaiser Permanente in Northern California, Southern California, and Washington, and HealthPartners in Minnesota. They all had a body mass index (BMI) of at least 35, and researchers attempted to group them together by age, gender, blood sugar levels, and other factors.

Of the total group, over 5,300 patients underwent surgery and roughly 15,000 patients received the regular care of insulin or diabetes medicines. Those who had surgery experienced fewer strokes and heart attacks than patients who received regular diabetes care.

Although researchers cannot prove a cause-and-effect relationship between weight loss surgery and the risk of stroke and heart attack, the suggestion that the two may be related indicates that weight loss surgery should at least be a more frequent discussion among patients and their physicians.

Treating a Gunshot Wound


Zachary Lutsky
Zachary Lutsky

Dr. Zachary Lutsky worked at Cedars-Sinai Medical Center in Los Angeles, California, a level 1 trauma Center, where he was an attending physician. In this role, Dr. Zachary Lutsky handled all manner of emergency medical issues, including the treatment of gunshot wounds.

Due to its unusual and unpredictable nature, a gunshot wound requires significant care in treatment, and no two are ever quite alike. They can change significantly due to location, projectile size, and projectile speed. Initial care for gunshot wounds, before surgical options begin, must pay attention to these issues.

Positioning the patient appropriately can help save a life. If the gunshot wound is above the waist but not in the arm, the patient’s legs should not be elevated, as this can increase bleeding. Patients should be in a comfortable position if conscious or be placed in the recovery position if unconscious or unresponsive. They should also avoid eating or drinking once injured.

At the hospital, gunshot wounds will generally be treated like other puncture wounds, barring complications from related injuries such as broken bones or bullet fragments. The patient should be in an ambulance or at a medical facility within 10 minutes of the injury.

Phone Call Helps Trauma Patients Headed to Hospital


Zachary Lutsky
Zachary Lutsky

Board certified in emergency medicine, Dr. Zachary Lutsky serves as an attending physician in the Emergency Department at Santa Clara Valley Medical Center. With experience in areas ranging from treating strokes to gunshot wounds, Zachary Lutsky, MD, knows the importance of managing trauma patients on their way to the emergency room.

Following a severe accident, as a patient is rushed to the hospital, the emergency medical services (EMS) team prepares for effective treatment by calling ahead to alert the hospital about the patient’s need for immediate care. This call can save valuable time by preparing the emergency room staff members who can set up any needed equipment or prepare for a blood transfusion or other critical procedure.

The EMS team must communicate to the hospital important information such as the patient’s age and gender, how the trauma happened, and what the injuries appear to be. It will also share vital signs, including pulse and blood pressure, to provide further context for treatment.

Studies have shown the critical importance of this phone call for providing effective trauma care, even with minimal time before arrival at the hospital.