Shock and Hypoperfusion. Introduction and History. Ambroise Pare first described symptoms in 1575 French surgeon LeDran 1743 used term “Shock” WW I reduction of O2 to tissues, lactic acidosis (Mcleod) Renal failure Korean War 1970 Swan Ganz catheter and numbers. Basic Mechanisms.
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Class I (15%): Like giving blood
Class II (15-30%): 800-1500c.Tachycardic, orthostatic, decreased pulse pressure,cool clammy.
Class III (30-40%): 2000cc. Hypotension, urine drop, anxiety, combative.
Class IV: >40%. Obtunded, oliguria, ready to code.