In any type of shock, rapid treatment is essential. Delays in therapy increase the risk of mortality. This is often done as diagnostic assessment is still occurring. Resuscitation addresses the ABC's - airway, breathing, and circulation. Supplemental oxygen is given, and intubation is performed if indicated. Intravenous fluids can increase blood pressure and maintain blood flow to organs. However, fluids should be given with caution. Too much fluid can cause overload and pulmonary edema. In some cases, fluids may be beneficial. Fluids can improve venous return. For example, tamponade prevents normal cardiac filling due to pressure compressing the heart. In this case, giving fluids can improve right heart filling. However, in other causes of<unk> , too much fluid can worsen cardiac output. Thus, fluid therapy should be monitored closely. After these stabilizing measures, further treatment depends on the cause. Treatment of the underlying condition can quickly resolve the shock. For tension pneumothorax, needle decompression should be done immediately. A chest tube is also inserted. Cardiac tamponade is treated through needle or surgical decompression. Needle pericardiocentesis can be done at the bedside. This is often the preferred therapy. A catheter may be placed for continued drainage. If these methods are not effective, surgery may be needed. Pericardial window is a surgery that is particularly in cases of cancer. Massive pulmonary embolism requires thrombolysis or embolectomy. Thrombolysis can be systemic via IV alteplase (tPA) or catheter-directed. tPA works to break up the clot. A major risk of tPA is bleeding. Thus, patients must be assessed for their risk of bleeding and contraindications. Catheter-directed therapy involves giving tPA locally in the pulmonary artery. It can also fragment and remove the clot itself (embolectomy). This local therapy has a lower risk of bleeding. Surgical embolectomy is a more invasive treatment, associated with 10-20% surgical mortality risk.
Obstructive shock
Distributive shock
Hypovolemic shock
Cryptic shock
Neurogenic shock
Vasodilatory shock
Septic shock
Cardiogenic shock