Shock

The recognition, assessment, and rapid treatment of shock represent a cornerstone of the practice of emergency medicine. Shock results from the failure of adequate perfusion, which results in the impaired delivery of metabolic substrates, including oxygen, to peripheral tissues. The consequence of this process is end-organ damage. Shock can be diagnosed using a combination of vital signs, physical exam findings, and laboratory tests. It is caused by a variety of pathophysiologic conditions that cause some combination of hypovolemia, cardiac dysfunction, peripheral vasodilation, and/or direct cellular poisons. The goals of treatment involve rapid recognition and restoration of perfusion through rationally targeted therapies based on the observed clinical findings and the etiology of hypoperfusion.