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Shock is most commonly defined as the life-threatening failure of adequate…

- - - - Common causes are tension pneumothorax, superior vena cava syndrome, pulmonary embolism or abdominal compartment syndrome
- - - - Neurogenic shock is a haemodynamic event that can happen within 30 minutes of a spinal cord injury at T5 which lasts up to 6 weeks. This causes vasodilation without compensation, due to reduced vasoconstrictor tone causing pooling of blood in vessels which results in tissue hypo-perfusion and impaired cellular metabolism. Blocked SNS impulses from injury or spinal anaesthesia, depression of medulla vasomotor centre by opioids can all contribute to neurogenic shock.
        
        presents with hypotension and bradycardia due to massive vasodilation and unopposed parasympathetic stimulation, inability to regulate temperature, pulmonary dysfunction related to injury, bladder dysfunction, decreased integumentary perfusion, dry skin which is either warm or cool to touch. Paralysis may occur below lesion, decreased or absent reflex activity local to injury, bowel dysfunction
      - Anaphylactic shock acute reaction to irritant causing vasodilation, release of vasoactive mediators and increased capillary permeability which results in fluid leaking into interstitial space. Caused by blood products, insect bites, foods and additives, vaccines, latex.
        
        Presents with dizziness, chest pain, incontinence, swelling at lips or tongue, wheezing and stridor due to sever bronchospasm. Anxiety along with confusion and impending doom.
      - Septic shock systemic inflammatory response to suspected or documented infection. Presence of sepsis and hypotension despite adequate fluid resuscitation, in-adequate tissue perfusion causing tissue hypoxia. Myocardial depression Caused by microorganisms, hospital acquired infection, UTI, pneumonia, IDC. increased risk is observed in extreme age, decreased immunity
        
        Presents with hypotension, hypovolaemia, hyperventilation, oliguria, respiratory alkalosis, decreased or altered neurological status, GI dysfunction, increased of decreased temperature, ECG abnormalities,
- - - - Relative hypovolemia is due to fluid volume moving out of the vascular space into the extravascular space or third spacing. Caused by bowel obstruction, burns, long bone fractures and sepsis.
      - Absolute hypovolemia is due to an external loss of whole blood or other bodily fluid e.g. vomiting, diarrhoea, haemorrhage, fistula drainage, trauma, surgery, GI bleeding and diabetes mellitus.
- - - - Irreversible stage results in decreased perfusion from peripheral vasoconstriction and decreased CO exacerbate anaerobic metabolism. Multi-organ failure i.e. liver, lungs and kidneys produces waste i.e. urea, carbon dioxide which leads to death