Shock: Causes, initial assessment and investigations

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Shock may result from a number of distinct disease processes and it is commonly associated with trauma, infection and cardiovascular dysfunction. Shock results in significant morbidity and mortality and is a leading causes of death in hospital patients. In order to improve patient outcomes it is important to recognize shock early, then assess and treat the shocked patient in a systematic way. The clinical classification of shock into cardiogenic, obstructive, hypovolaemic or distributive shock can help the clinician to understand the underlying cause of the shock. However, it is important to note that considerable overlap between these different types of shock can exist in practice. After identification of patients in shock, immediate resuscitation with goal-directed therapy to prevent further deterioration and improve outcome is vital. ABCDE approach can be useful systematic way for initial assessment and resuscitation. Basic monitoring should be instituted as soon as possible and in severe or unresponsive shock this should be escalated to invasive monitoring. Immediate generic laboratory, microbiological and radiological tests should be carried out as soon as possible and should include a blood lactate level. Further targeted tests should then be tailored to the history and clinical findings. These targeted investigations should help to pin point the specific cause of the shock and drive definitive management.
Original languageEnglish
Pages (from-to)64 - 67
Number of pages4
JournalAnaesthesia and Intensive Care Medicine
Issue number2
Publication statusPublished - 2014

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