Shock

About Shock

Shock is a life threatening condition of inadequate tissue perfusion resulting in cellular hypoxia and organ dysfunction. Without prompt treatment, shock progresses to multi organ failure and death. Shock is a medical emergency; call your local emergency number. Types include hypovolemic from hemorrhage, severe dehydration, burns, distributive including septic, anaphylactic, and neurogenic, cardiogenic from myocardial infarction, arrhythmias, cardiomyopathy, and obstructive from tension pneumothorax, cardiac tamponade, massive pulmonary embolism. Recognizing shock early is critical. Signs include hypotension systolic BP below 90, tachycardia, tachypnea, cool clammy skin in hypovolemic and cardiogenic shock vs warm skin in early septic shock, weak pulse, prolonged capillary refill, reduced urine output oliguria, and altered mental status confusion, lethargy. The shock index heart rate divided by systolic BP above 0.8 suggests shock. Lactate elevation reflects tissue hypoxia. Treatment follows the ABCDE approach Airway, Breathing, Circulation, Disability, Exposure. Intravenous access is established and fluid resuscitation with crystalloids is given promptly, though fluids are used more cautiously in cardiogenic shock. Vasopressors norepinephrine for septic and neurogenic shock, epinephrine for anaphylactic shock, dobutamine for cardiogenic shock are started for refractory hypotension. The underlying cause must be addressed simultaneously hemorrhage control, antibiotics for sepsis, coronary intervention for MI. Survival depends on rapid recognition, aggressive resuscitation, and treatment of the cause.