Type of shock

Signs/Symptoms

Bodys Total Volume Loss

o <20% Pale, Cool and
Clammy skin with HR
o 2040% RR,
orthostasis, possibly
confusion, poor capillary
refill, peripheral pulses
o 40% Hypotension,
oliguria, and obtundation
Cardiogenic
Pale and Cool Ashen gray
Cool and clammy extremities
Narrowed pulse pressure
Diaphoresis
JVP
Rales/Crackles
Muffled heard sounds
Neurogenic Warm
Bradycardia
Flaccid paralysis

RA

CVP

PCWP/
LVEDP

SVR

HR

CO

Distributive

Hypovolemic

Warm and Faint

Flushing
(MCC: E. RR acute hyperventilation
Coli, and S.
(resp. alkalosis, (PCO2 < 30
Aureus)
mm Hg))
At-risk patients diabetics
and immunocompromised

Nl or

Septic

Etiology

Treatment

Lack of enough blood (due to loss) to

properly perfuse the bodymost
commonly due to trauma
o Massive Infarction
Fluids and
o Fluid loss (i.e., vomiting, diarrhea,
pressors
burns, or trauma)
o Preexisting heart disease may
exacerbate the effects of hypovolemic
shock.
Failure of the heart as a pump
o Myocardial Infarction myocardium
damaged heart cant effectively pump
Treat
o Acute mitral regurgitation heart is
cardiac
pumping enough blood, but much of it is problem
leaking back into LA instead of being
propelled out into aorta
Defect in the central nervous system
control of vascular tone results in
Fluids and
generalized dilation of vessels and
Pressors
consequent pooling of blood
o Spinal Cord Injury (Cervical/Thoracic)
2550% mortality rate;
Generalized vascular dilation caused by
infectious organism, usually due to
Fluids,
lipopolysaccharides (LPS) in cell wall of
Antibiotics,
gram-negative bacterial organisms such as
and
E. Coli, Pseudomonas, and Klebsiella.
Pressors
o Blood pools in venous system and
peripheral vasculature and not enough
returns to the heart to be pumped out
Mechanical obstruction of blood flow
through central circulation due to
Results in Right Heart Failure
o Right Heart Pressure
o Impaired venous return

Obstructive

RV infarct
Massive
Pulm.

Nl or

Embolism
Pneumothorax
Pericdial

Tamponade
CO=Cardiac Output; SVR=Systemic Vascular Resistance; PCWP=Pulmonary Capillary Wedge Pressure; LVEDP = Left Ventricular End Diastolic Pressure;
CVP=Central Venous Pressure; JVP = Jugular Venous Pressure; HR = Heart Rate; RR = Respiration Rate; = Increase; = Decrease; = No Change; Nl = normal

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