1. SHOCK PAYDAR MD DEPARTMENT OF GENERAL SURGERY TRAUMA RESEARCH CENTER SHIRAZ UNIVERSITY OF MEDICAL SCIENCES

2. What is DEFINITION of Shock?

3. Shock is defined as a state of acute inadequate or inappropriate tissue perfusion resulting in generalized cellular hypoxia and dysfunction.

4. What causes shock?

7. Hypovolaemic Blood loss (trauma, ruptured abdominal aortic aneurysm, upper GI bleed, etc.). Plasma loss (burns, pancreatitis). Extracellular fluid losses (vomiting, diarrhea, intestinal fistula).

8. Cardiogenic Myocardial infarction. Dysrhythmias (AF, ventricular tachycardia, atrial flutter). Pulmonary embolus. Cardiac tamponade. Valvular heart disease

9. Septic Gram-negative or, less often, gram-positive infections. Fungal – usually Candida albicans. Septic shock often caused by underlying GU or biliary problem

10. Anaphylactic/distributive Release of vasoactive substances when a sensitized individual is exposed to the appropriate antigen.

11. What Happens in Response to Shock?

12. What we see while facing to patient in shock?

15. What to do while facing to patient in shock?

19. Key points Identify the cause early and begin treatment quickly. Shock in surgical patients is often overlooked – unwell, confused, restless patients may well be shocked. Unless a cardiogenic cause is obvious, treat shock with urgent fluid resuscitation. Worsening clinical status despite adequate volume replacement suggests the need for intensive care.

21. ANY COMMENT?

22. THANK YOU!