Hypotension or shock
Framing
- Shock is classified by underlying mechanism - hypovolaemic (reduced circulating volume), cardiogenic (pump failure), septic and anaphylactic (distributive, vasodilation-driven), and neurogenic (loss of sympathetic vascular tone) - each requiring a distinct primary treatment approach (fluid resuscitation, inotropic support, source control/vasopressors, or specific mechanism-targeted treatment respectively) despite sharing the common endpoint of inadequate tissue perfusion
- Correctly identifying the shock mechanism, rather than applying a generic "give fluids" response to every hypotensive patient, is essential given that the correct treatment for one shock type can be ineffective or harmful in another (e.g. aggressive fluids in cardiogenic shock)
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