SHOCK SPOT AND TREAT

8. PRESENTATION OF SHOCK

A patient with a history of having had any one of the causative
events listed under Shock syndrome presents with:

* Pallor best seen on the face
* Cold moist skin of the extremities(vasoconstriction of skin
vessels)
* Rapid weak pulse (>90/min) and a collapse of superficial veins
because of compensatory peripheral vasconstriction
* Cyanosis and rapid shallow breathing (air hunger)
* Patient may have tendency to vomit and is restless,
later there may be diminishing sensibility, drowsiness and
coma
** On examination there is a declining pulse pressure
followed latter by a drop in blood pressure (systolic < 90 mm
of Hg)

9. MONITORING

In an average hospital or Nursing home, the patient with any of the shock syndromes, is observed, and progress assessed, recording the following
parameters:

* Blood pressure
* Central Venous pressure
* Haematocrit
* Arterial blood gases
* Urine output

All these values, if altered, are the late manifestations of shock.
Thus it is difficult to assess the treatment of shock.
Normal values may not reflect reversal of shock and give no indication of tissue perfusion or O2 debt. Thus silent hypoxia remains undetected.
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