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, restore volume, or support the heart.
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