Recognition and management of the patient with shock

The term shock probably originates from an inappropriate English translation of the word choc, which was used by the French army surgeon Henri Francois Le Dran to describe the collapse of vital functions culminating in death that he observed in soldiers who had been struck by missiles. In the 1800's John Collins Warren described shock as a 'momentary pause in the act of death', a description which remains accurate to this day if the diagnosis is missed or delayed. Shock can be considered as the final pathway through which a variety of pathological processes lead to cardiovascular failure and death. Given the enormous spectrum of disease that can lead to shock it is not surprising that it is an extremely common cause of admission to the intensive care unit.