Basics of shock

1. Big picture

Shock is acute circulatory failure causing inadequate tissue oxygen delivery. In surgery, shock is a life-threatening emergency because it commonly results from bleeding, sepsis, trauma, perforation, pancreatitis, burns, pulmonary embolism, cardiac failure, or anesthesia-related events.

The examiner wants you to think like this:

Shock = tissue hypoperfusion
→ cells switch to anaerobic metabolism
→ lactate rises
→ organs fail
→ death unless circulation and oxygen delivery are restored

The most important surgical principle:

Do not only raise the blood pressure. Find and treat the cause of shock: stop bleeding, control sepsis, relieve obstruction, re