This document discusses circulatory shock and its types. It defines circulatory shock as inadequate tissue perfusion due to decreased cardiac output. The main types are hypovolemic, distributive, cardiogenic, and obstructive shock. Hypovolemic shock, the most common type, can be caused by hemorrhage, trauma, surgery, or burns. Hemorrhagic shock specifically results from acute blood loss of over 15ml/kg. The stages of shock include a reversible stage with rapid compensatory mechanisms and a later irreversible stage if compensation fails. Treatment focuses on blood and plasma transfusion as well as medications like epinephrine and dopamine to increase cardiac output, while avoiding sedatives and overwarm

2. CIRCULATORY SHOCK
 Syndrome in which there is inadequate tissue
perfusion associated with relative or absolute decrease
in cardiac output.
TYPES
Hypovolemic shock
Distributive shock
Cardiogenic shock
Obstructive shock

3. HYPOVOLEMIC SHOCK
 Commonest of all shocks.
 Common forms: Hemorrhagic, traumatic, surgical and
burn shocks.

4. HEMORRHAGIC SHOCK
 Commonest of all shocks.
 Cause : Acute hemorrhage of more than 15ml/kg body
weight.
 Features:
 Hypotension
 Tachycardia, Tachypnoea
 Restlessness
 Rapid and thready pulse
 Cold and pale skin
 Intense thirst
 Usually conscious

5. STAGES OF SHOCK

6. REVERSIBLE STAGE
 Rapid compensatory mechanisms
 Long-term compensatory mechanisms

7. RAPID COMPENSATORY MECHANISMS
1. Tachycardia
2. Vasoconstriction
3. Increased venous return
4. Increased thoracic pumping
5. Increased skeletal muscle pumping
6. Capillary fluid shift
7. Activation of chemoreceptor reflex
8. Activation of Cushing’s reflex
9. Increased secretion of Catecholamines
10. Increased secretion of vasopressin
11. Increased secretion of Cortisol
12. Activation of Rennin-Angiotensin system
13. Increased secretion of Aldosterone

8. LONG-TERM COMPENSATORY MECHANISMS
1. Increased synthesis of Erythropoietin
2. Increased plasma protein synthesis

9. IRREVERSIBLE SHOCK
 Compensatory mechanisms fail to improve body
functions.
 Refractory shock or irreversible shock.

10. FEATURES
 Pre-capillary sphincters constrict
 Pre-capillary sphincters dilate
 Entry of bacteria into circulation
 Cardio-respiratory centres depressed
 Myocardial function decreases
 Disseminated intravascular coagulation
 Pulmonary microembolism

11. OTHER TYPES
 Distributive shock
a) Anaphylactic shock
b) Septic shock
c) Endotoxic shock
d) Neurogenic shock
 Cardiogenic shock
 Obstructive shock

12. TREATMENT OF SHOCK
 Blood transfusion
 Plasma transfusion
 Epinephrine
 Dopamine
 No sedatives
 Prevent over-warming of body

13. -R.MARIA JECINTHA RINA