More than 1 million cases of shock are estimated to present to U.S. hospital EDs each year. (1) The presentation may be cryptic, as in the patient with compensated heart failure, or obvious as in the ultimate shock state of cardiac arrest. Despite aggressive treatment, mortality
from shock remains high. Approximately 30 to 45 percent of patients in septic shock, and 60 to 90 percent for those with cardiogenic shock, die within 1 month of presentation. (2,3) The definition and treatment of shock continues to evolve. With a contemporary understanding of the disease and new evolving technology, the emergency physician can recognize shock at an earlier stage and initiate expert, timely intervention. The general approach to a patient in the initial stages of shock follows similar principles regardless of the inciting factors or etiology
Key words: Shock, peripheral circulatory failure, cardiogenic shock ,anaphylactic shock.
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