1. Dr.Aye Aye Chit
C.S, Lecturer
MU I, MGH.

2. Definition
 Shock is a physiological state
characterized by a significant systemic
reduction in perfusion resulting in
decreased tissue oxygen delivery.

3. Causes / Classification
1. Hypovolumic shock
2. Cardiogenic shock
3. Neurogenic shock
4. Analphalatic shock
5. Septic shock
6. Obstructive shock

4. Introduction
 Imbalance between O2 demand and
supply.
 Inadequate tissue perfusion leading to
cellular hypoxia.
 Derangement of critical biochemical
processes such as cell membrane ion
pump dysfunction, intracellular edema,
leakage of IC contents to EC space.

5.  Initially reversible and rapidly irreversible
cell death and organ demage.
 The mortality remains high.
 Septic shock -35-40 %
 Cardiogenic shock -60-90 %
 Hypovolumic shock -variable

6. Management
 Initial assessment –
pulse,BP,RR,Temp,urine output.
 Resuscitation - 0 care of ABC
 Urgent investigation – ECG and cardiac
enzymes, Hb,urea and electrolytes, G &
M, arterial blood gas , blood culture.
 Appropiate treatment of underlying
causes.

7. 1. Hypovolumic shock
 Care of A – keep the air way patent.
 Care of B – give 100% oxygen via face
mask.
 Care of C – restore circulation by blood
or crystalloids depend on the
cause.

8. 2. Cardiogenic shock
 Bed rest
 Analgesia
 Asprin and thrombolictic therapy in AMI
 Treat heart failure
 Treat arrhythmias

9. 3. Septic shock
 Fluids
 Antibiotics and surgery
 Inotropes – Dopamine, Dobutamine,
Adrenalin, Noradrenalin

10. 4. Analphylatic shock
 IV fluids
 Adrenalin
 Antihistamine
 Hydrocortisone