Stages of shock Compensated shock Early, compensatory sympathetic stimulation Altered level of consciousness, Increased pulse rate Increase respiratory rate Pale clammy skin Normal blood pressure
Decompensated shock late stage Body looses ability to compensate Rapid weak pulse Shallow respiration Extreme weakness Pallor,cyanosis Drop in blood pressure oliguria
Irreversible shock Terminal stage Organs suffer prolonged hypoxia Return of function is irreversible despite aggressive adequate intervention Unresponsiveness Profound hypotension Severe bradycardia Apnea Fixed dilated pupils
Presentation Shock presents by Altered mental status Hypotension Increased pulse rate Increased respiratory rate Oliguria Cold pale skin,warm skin is seen in distributive shock Manifestation of cause
Principles of management General management principles 1.Golden hour. 2.Establish clear airway,adequate ventilation 3.Oxygen 4.Adequate intravenous access 5.Continuous cardiac monitoring 6.Urinary catheter 7.Record fluid balance 8.Maintain optimum temperature 9.Blood gases 10.Inotropes and vasoconstrictors may be used 11.Assess the response 12.Treat underlying cause.