The Seriously Ill Patient : Part 4 - Circulatory Shock

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The Seriously Ill Patient : Part 4 - Circulatory Shock

Recognising and Responding to the Seriously Ill Patient

Part 4 : Circulatory Shock

Circulatory Collapse (or Shock) is a clinical diagnosis and describes the syndrome of widespread ischaemia and cellular damage that results from inadequate perfusion of critical organs. It is characterised clinically by evidence of tissue and organ hypoperfusion and identified clinically by altered conscious state, oliguria / anuria, hypotension and elevated serum lactate.

There are three types of Circulatory Shock depending on the part of the circulatory system most affected by the underlying disease process – the fluid, the pump or the plumbing (pipes)

  • Fluid (Blood Volume)                    Hypovolaemic Shock

  • Pump (Heart Function)                 Cardiogenic Shock

  • Plumbing (Vessel Tone)                Vasogenic Shock

In this topic we explore the clinical features of circulatory shock focusing particularly on the early signs of shock such as symptomatic thirst, tachycardia and cutaneous vasoconstriction. While the causes and types of shock vary the management remains limited to 3 basic interventions : IV fluids, inotropic drugs and treatment of the cause and these will be discussed in detail in the Case Simulation in relation to a patient presenting with hypovolaemic shock.

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