approach to shock

1. APPROACH TO Orthostatic
Hypotension and SHOCK
DR.Bilal Natiq Nuaman,MD
C.A.B.M. , F.I.B.M.S. , D.I.M. , M.B.Ch.B.
Lecturer in Al-Iraqia Medical College
2018-2019

2. Orthostatic Hypotension

4. • Orthostatic hypotension has been observed in
all age groups, but it occurs more frequently in
the elderly, especially in persons who are sick
and frail. It is associated with several diagnoses,
conditions, and symptoms, including
• lightheadedness soon after standing,
• an increased rate of falls, and
• a history of myocardial infarction or transient
ischemic attack;
• it also may be predictive of ischemic stroke.

6. Shock is a clinical syndrome characterized
by inadequate systemic and specific organ
perfusion. It is recognized by features of tissue
hypoperfusion, usually with hypotension;
however, BP may be maintained until the
advanced stages of shock, particularly in young,
fit individuals.

11. During resuscitation, one needs a quick starting
point when assessing the causes of shock. One way
to categorize shock is to differentiate causes with
wide pulse pressure and narrow pulse pressure
(‘pulse pressure’ is the difference between systolic
and diastolic blood pressure)

17. Causes

18. Stages of hypovolemia
Mild hypovolemia (< 15% loss)-1
2-Moderate hypovolemia (15 - 40% loss)
3-Severe hypovolemia (> 40% loss)

25. Stages of septic shock
((Systemic Inflammatory Response Syndrome