The document discusses different types of shock. It defines shock as a state in which the oxygen and metabolic demands of the body are not met by the cardiac output. There are four main classifications of shock: hypovolemic, cardiogenic, obstructive, and distributive. Hypovolemic shock is specifically caused by a loss of intravascular volume from sources like trauma, ruptured aneurysms, bleeding ulcers, or pregnancy complications. The document provides a table classifying the severity of hypovolemic shock based on factors like blood loss percentage, blood pressure, pulse, and mental state.

1. SHOCK
By:
Ismah-Nuramalina-Kauthar-Khiddir-Norashikin-Bashirah-Fazwan

2.  Shock is "a momentary pause in the act of death."--
John Collins Warren
 Mid 1800s
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Source: Oregon Health & Science University ; http://ohsu-hca.blogspot.com/

3.  A state in which the oxygen and metabolic demands
of the body are not met by the cardiac output
What is shock?
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Source: An Introduction to Clinical Emergency Medicine. Swaminatha V.M and Gus M.G. Cambridge University Press; 2005.

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SHOCK
hypovolemic
cardiogenic
obstructive
distributive
Classification
Source: An Introduction to Clinical Emergency Medicine. Swaminatha V.M and Gus M.G. Cambridge University Press; 2005.

5. Hypovolemic Shock
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6.  The loss of intravascular volume
Definition
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Source: An Introduction to Clinical Emergency Medicine. Swaminatha V.M and Gus M.G. Cambridge University Press; 2005.

7.  Traumatic
 Vascular
- e.g. ruptured aneurysm, arterial dissection
 Gastrointestinal
- e.g. bleeding peptic ulcer
 Pregnancy related
- e.g. ruptured ectopic pregnancy
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Causes
Source: http://emedicine.medscape.com/article/760145-clinical#a0218

8. Class I Class II Class III Class IV
Blood loss
(%, ml)
<15, 750 15-30,
800-1500
30-40,
1500-2000
>40,
>2000
Blood pressure
(Systolic,
Diastolic)
Unchanged,
unchanged
Normal, raised Reduced, reduced Very low, very low
or unrecordable
Pulse (bpm) Slight tachycardia 100-120 120, thready >120, very thready
Capillary refill
time
Normal Slow, >2s Slow, >2s Undetectable
Respiratory rate Normal Normal Tachypnea,
>20/min
Tachypnea,
>20/min
Urinary flow rate
(ml/h)
>30 20-30 10-20 0-10
Extremities Color normal Pale Pale Pale and cold
Complexion Normal Pale Pale Ashen
Mental state Alert Anxious or
aggressive
Anxious,
aggressive or
drowsy
Drowsy, confused
or unconscious
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Classification (Blood loss)
Source: ABC of Major Trauma. BMJ.

9.  Hemorrhagic hypovolemic shock
- External and internal bleeding
 Non hemorrhagic hypovolemic shock
- Severe dehydration or fluid losses
- E.g. in Diabetic Ketoacidosis, Cholera
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Types

10. THANK YOU
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