Understanding shock in children

Shock is an unstable physiological state that occurs following acute failure of the circulation, which results in inadequate tissue perfusion and oxygenation and incomplete removal of harmful metabolic waste products. Shock leads to a decrease in intravascular volume, a disruption to circulating intravascular volume, or impaired cardiovascular function (Waltzman, 2015). Recognising shock can be difficult as the signs and symptoms of shock are not those of the underlying disease/process, but the body's attempts to maintain homeostasis by preserving an effective circulation (Cameron et al, 2019). If shock is not recognised, anaerobic metabolism and tissue acidosis will result; if these changes are not reversed, end organ failure will follow (Crisp and Rainbow, 2007).