This document discusses shock and its pathophysiology. It emphasizes the importance of properly monitoring patients in shock and using early vasopressors if needed. The assessment of shock patients should include documentation, clinical appearance, adequate volume resuscitation, checking for potential causes of hidden bleeding or injuries, and ruling out adrenal insufficiency or medication reactions. Fluid resuscitation for shock can utilize crystalloids like normal saline or lactated Ringer's solution, or colloids like albumin, hydroxyethyl starch, or dextran. Bicarbonate may be used to treat acidosis in shock but should be administered slowly and stopped once pH reaches 7.25.

1. SHOCK
Dr. Swarnalingam Thangavelu M.D
Associate Professor
Department of Anaesthesiology,
Tagore medical college & hospital

2. BASICS
PATHOPHYSIOLOGY OF SHOCK

4. Equipment and
Monitoring
Patient
Assessment

5. Equipment and Monitoring
 Appropriately monitored ?
 Early use of vassopressors ?
 Equipment malfunction ?
 IV Tubing-Connected appropriately ?
 Infusion pump ?
 Mixing of vasopressors and dosage ?

6. Patient Assessment
 Do mentation and clinical appearance match the
degree of hypotension?
 Adequate volume resuscitation?
 Pneumothorax after central venous access?
 Occult penetrating injury?
 Hidden bleeding?
 Adrenal insufficiency?
 Medication allergy ?
 Cardiac tamponade ?
 Acute coronary syndrome ?

7. Fluid Therapy
Bicarbonate
Usage

8. Crystalloids Colloids

9. Normal Saline
Lactated
Ringer’s
Solution

10. Albumin
Hydroxy
ethyl
starch
Dextran
Gelatin

11.  Calculate the Bicarbonate deficit
 Slowly infuse one half of the calculated deficit
 Infuse the reminder over 6 to 8 hours
 Stop Bicarbonate when arterial pH Equal to 7.25