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Ms. L, a 19-year-old woman with no previous medical history, was involved in a serious automobile accident in which her best friend died. Examination by EMT personnel first on the scene revealed she had only minor scrapes and bruises and no sign of head trauma. While en route by ambulance to the hospital, Ms. L complained of thirst and appeared restless. Further examination indicated a rapid pulse and respirations, with her blood pressure now at 100/60 mm Hg. She appeared less responsive to the paramedics. She was slipping into circulatory shock as they checked her again for internal injuries. Discussion Questions Discuss the contributing factors to shock in this case and the pathophysiologic changes causing the changes in vital signs. (See Shock-Neurogenic.) Discuss the signs and symptoms of shock, including the rationale for each, as seen in the early stage, and as compensation mechanisms respond. (See Shock-Etiology.) Discuss emergency and follow-up treatment for shock and for complications that may arise if not treated quickly. (See Shock-Treatment.) Compare the types of shock, giving a specific cause, classification, and any significant changes in onset or manifestations.
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