What patient education is necessary after experiencing shock, including when to seek emergency department (ED) care?

Patient Education After Experiencing Shock: When to Return to the Emergency Department

If you have experienced shock, you should return to the ED immediately if you develop repeated vomiting, worsening symptoms, confusion, abnormal behavior, increased sleepiness or passing out, seizures, or any new concerning symptoms—do not wait to see if symptoms improve on their own. 1

Immediate Warning Signs Requiring 9-1-1 Activation

Call 9-1-1 immediately and do not drive yourself if you experience any of these symptoms: 1

• Chest discomfort or pain that is new, worsening, or unimproved after 5 minutes, especially if it feels like pressure, heaviness, or tightness in the center of your chest 1
• Severe shortness of breath or difficulty breathing 1
• Chest pain radiating to your arms, jaw, neck, or back 1
• Sweating (diaphoresis) with chest discomfort 1
• Nausea or vomiting with chest symptoms 1
• Feeling like you might pass out or loss of consciousness 1
• Seizures or convulsions 1

Symptoms Requiring Prompt ED Evaluation (Within Hours)

Return to the ED for re-evaluation if you develop: 1, 2

• Repeated or persistent vomiting 1
• Worsening headache that doesn't improve with rest 1
• New or worsening confusion or problems with memory 1
• Abnormal behavior or personality changes 1
• Increased sleepiness beyond normal fatigue 1
• New weakness on one side of your body or difficulty moving 1
• Persistent dizziness or balance problems 1
• Vision problems or increased sensitivity to light 1

Common Symptoms After Shock That May Occur

You may experience some of these symptoms in the days following your shock episode, but they should gradually improve. If they worsen or persist beyond 2-3 weeks, seek medical follow-up: 1, 3

• Increased heart rate or sensation of a more forceful heartbeat 3
• Palpitations or irregular heartbeat sensations 3
• Mild sweating 3
• Mild nausea 3
• Pallor (pale appearance) 3
• Mild dizziness or shakiness 3
• Headache 1, 3
• Apprehension, nervousness, or anxiety 3
• Fatigue or feeling tired 1

These symptoms usually subside rapidly with rest and lying down. 3

Special Considerations

For patients with diabetes: You may develop increased blood glucose levels following treatment for shock, so monitor your blood sugar more frequently in the days following your episode. 3

For patients who received epinephrine injection: Watch the injection site for signs of infection including persistent redness, warmth, swelling, or tenderness. Seek medical care immediately if these develop, as rare but serious skin infections can occur. 3

Recurrence of symptoms: Even if you initially felt better after treatment, symptoms can return. Do not hesitate to call 9-1-1 if your symptoms come back. 3

What NOT to Do

• Do not drive yourself to the hospital if you are experiencing chest pain or other serious symptoms—call 9-1-1 for ambulance transport 1
• Do not wait more than 5 minutes after chest discomfort begins to call for help 1
• Do not assume symptoms will resolve on their own—early recognition and treatment significantly improve survival 1

Activity Restrictions

Avoid strenuous mental or physical activity until you are symptom-free and have been cleared by your physician. You may require 2-3 days off work or school depending on your symptoms. 1