Vol. 20 No. 2 (2022)
An Approach To:

Approach to Shock

PDF HTML
  • Janet Chan
Janet Chan
McGill University
DOI: https://doi.org/10.26443/mjm.v20i2.872

Published 2022-04-19

Keywords

  • shock,
  • vasopressors,
  • inotropes,
  • cardiogenic shock,
  • neurogenic shock,
  • obstructive shock,
  • anaphylactic shock,
  • hypovolemic shock,
  • septic shock
    • ...More
    Less

How to Cite

1.
Chan J. Approach to Shock. McGill J Med [Internet]. 2022 Apr. 19 [cited 2025 Oct. 30];20(2). Available from: https://mjm.mcgill.ca/article/view/872

Copyright (c) 2022 Janet Chan

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

Crossref
Scopus
Google Scholar
Europe PMC

Abstract

Shock is a life-threatening pathophysiologic state referring to inadequate organ perfusion, which can progress to end-organ dysfunction and eventually, multiple organ failure and death. The diagnosis of shock is clinical, necessitating good understanding of the underlying etiology, pathophysiology, as well as the clinical, biochemical, and hemodynamic manifestations of the various presentations of shock. This article describes an approach to shock, highlighting the important initial actions, pertinent clinical findings, and the four main types of shock, and offers an overview of the inotropes and vasopressors used in the intensive care setting. A case study and additional figures are included to supplement the presented concepts.

PDF HTML

Downloads

Download data is not yet available.

References

  1. USMLE Step 1: Diagnose a patient in shock. American Medical Association. 2021. Available from: https://www.ama-assn.org/residents-students/usmle/usmle-step-1-diagnose-patient-shock
  2. Shock. AMBOSS. 2021. Available from: https://www.amboss.com/us/knowledge/Shock
  3. Sandefur B. Approach to Shock. Saem.org. 2019. Available from: https://www.saem.org/cdem/education/online-education/m3-curriculum/group-stabilization-of-the-acutely-ill-patient/approach-to-shock
  4. Colwell C, Moreira M, Grayzel J. Geriatric trauma: Initial evaluation and management. In: UpToDate. Waltham, MA: UpToDate; 2021.
  5. VanValkinburgh D, Kerndt C, Hashmi M. Inotropes And Vasopressors. Ncbi.nlm.nih.gov. 2021. Available from: https://www.ncbi.nlm.nih.gov/books/NBK482411/
  6. Southern A, Lopez R, Jwayyed S. Geriatric Trauma. Ncbi.nlm.nih.gov. 2021. Available from: https://www.ncbi.nlm.nih.gov/books/NBK442020/
  7. Cardiovascular examination. Amboss.com. 2021. Available from: https://www.amboss.com/us/knowledge/Cardiovascular_examination
  8. Cardiac physiology. Amboss.com. 2021. Available from: https://www.amboss.com/us/knowledge/Cardiac_physiology
  9. Arterial blood gas analysis. Amboss.com. 2021. Available from: https://www.amboss.com/us/knowledge/Arterial_blood_gas_analysis
  10. Wittayachamnankul B, Apaijai N, Sutham K, Chenthanakij B, Liwsrisakun C, Jaiwongkam T et al. High central venous oxygen saturation is associated with mitochondrial dysfunction in septic shock: A prospective observational study. Journal of Cellular and Molecular Medicine. 2020;24(11):6485-6494.
  11. Whitson M, Mayo P. Ultrasonography in the emergency department. Critical Care. 2016;20(1).
  12. Levi M, Sivapalaratnam S. Disseminated intravascular coagulation: an update on pathogenesis and diagnosis. Expert Review of Hematology. 2018;11(8):663-672.
  13. Gaieski D, Mikkelsen M, Parsons P, Hockberger R, Finlay G. Evaluation of and initial approach to the adult patient with undifferentiated hypotension and shock. In: UpToDate. Waltham, MA: UpToDate; 2021.
  14. Morris M, Todres I, Schleien C. Cardiopulmonary Resuscitation. A Practice of Anesthesia for Infants and Children. 2009;:833-845.