**12. Conclusion**

Shock is a state of global tissue hypoperfusion. After initial resuscitation, detailed physical examination is important to determine the cause of shock. Patients in shock have to be kept on monitored bed. Urine output and central venous pressure would need to be monitored in such patients [2].

In trauma patients, hypovolemia is the main reason for shock. Control of hemorrhage and blood replacement are necessary. Hypovolemia can also develop due to gastroenteritis, heat stroke, febrile illness, etc. Septic shock needs early administration of antibiotics, after drawing a full septic workup. Cardiogenic shock needs to be treated meticulously and monitored closely. Inotropes and fluids have to be administered, cautiously. Neurogenic shock needs good vasopressor support. Obstructive shock whether it is tension pneumothorax or pericardial tamponade, both, need decompression. Pulmonary embolism needs to be treated with anticoagulants. Anaphylactic shock can be managed by administration of parenteral epinephrine, crystalloids, steroids, and antihistamines [3].

Management of shock is often complicated especially in extremes of age, pregnancy, and patients with multiple comorbidities [2].
