shock overview - Defination,signs,symptoms

shock is an important topic for surgeons gp etc

1. Shock - An Overview A state of circulatory failure leading to inadequate tissue perfusion and organ dysfunction.

2. Types of Shock 1. Hypovolemic - Fluid loss 2. Cardiogenic - Heart failure 3. Distributive - Vasodilation 4. Obstructive - Circulatory obstruction

3. Hypovolemic Shock Caused by blood or fluid loss, leading to reduced preload and cardiac output. Examples: Trauma, GI bleed, burns.

4. Cardiogenic Shock Due to intrinsic heart failure, causing inadequate cardiac output. Examples: MI, arrhythmias, myocarditis.

5. Distributive Shock Systemic vasodilation leading to relative hypovolemia. Includes: Septic, Anaphylactic, Neurogenic, Endocrine shock.

6. Obstructive Shock Mechanical obstruction to circulation impairs cardiac output. Examples: Tension pneumothorax, cardiac tamponade, PE.

7. Pathophysiology Inadequate perfusion → Cellular hypoxia → Anaerobic metabolism → Lactic acidosis → Organ dysfunction.

8. Clinical Features Hypotension, tachycardia, altered mental status, cold/clammy skin, oliguria, metabolic acidosis.

9. Diagnosis Clinical assessment, ABG (lactic acidosis), CBC, coagulation profile, ECG, echocardiography, imaging (X-ray, CT, FAST).

10. Management - ABCDE Approach A - Airway B - Breathing C - Circulation D - Disability E - Exposure

11. Fluid Resuscitation Crystalloids (Ringer’s lactate, Normal saline) are first-line. Blood transfusion if hemorrhagic shock.

12. Vasopressors & Inotropes Norepinephrine (septic shock), Dobutamine (cardiogenic shock), Epinephrine (anaphylactic shock).

13. Complications Acute kidney injury, DIC, ARDS, multi-organ failure, death if untreated.

14. Prevention & Prognosis Early recognition and aggressive management improve survival. Preventive strategies: fluid management, early antibiotics, DVT prophylaxis.

15. Key Takeaways Shock is a medical emergency. Early recognition and treatment improve outcomes. Fluids, vasopressors, and addressing the cause are key to survival.