Early Vs Late Shock

Shock is a life-threatening state of circulatory failure in which oxygen delivery or utilization is inadequate to meet tissue metabolic requirements. Every cell needs a continuous supply of oxygen and fuel and a way to wash away waste. When the circulation cannot provide that, cells shift to less efficient metabolism, organs begin to fail, and, if nothing interrupts the process, the injury becomes irreversible. The most important idea in this topic is that shock is not defined solely by low blood pressure. Blood pressure is a number the body defends very hard, using its fastest reflexes, and it is one of the last things to give way. A patient may have significant tissue hypoperfusion despite a normal blood pressure. The nurse who waits for a low reading is waiting for the late sign. Consider a 74-year-old patient admitted with pneumonia who develops a temperature of 39.2°C, HR 124/min, RR 28/min and BP 112/68 mmHg. The patient is restless, has warm extremities and a capillary refill of 2 seconds. Lactate is 3.4 mmol/L. Nothing on that list is a low blood...