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Assessment & Critical Care · Chapter 10 Not started
Shock
Recognizing failing perfusion early — when treatment still works — and slowing its progression.
Key points
- Shock is inadequate tissue perfusion. Categories include hypovolemic, cardiogenic, distributive (septic, anaphylactic, neurogenic), and obstructive.
- Early (compensated) signs: anxiety, tachycardia, pale cool clammy skin, thirst, delayed capillary refill. Falling blood pressure is a late, decompensated sign.
- In the outdoor setting, hypovolemic shock from bleeding — internal or external — is the type you'll see most; find and control the bleeding.
- Treatment: control hemorrhage, keep the patient supine, prevent heat loss aggressively, give oxygen if available, and nothing by mouth.
- Cold multiplies shock: a cold patient clots poorly and deteriorates faster — insulate from the snow below as well as above.
- Shock is a load-and-go problem: rapid packaging and transport beat prolonged on-hill care.
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