SU2.1-3 | Shock and Resuscitation — Glossary

The systematic trauma assessment — Airway, Breathing, Circulation, Disability, Exposure — performed in parallel with resuscitation.

A four-class system (I <15%, II 15–30%, III 30–40%, IV >40% blood loss) relating estimated blood loss to heart rate, blood pressure, urine output and mental state.

The ethical principle that a patient with capacity has the right to information and to make decisions about their own care.

Transfusing packed red cells, fresh frozen plasma and platelets in roughly equal proportions in massive haemorrhage to replace blood and correct coagulopathy.

The amount of base needed to correct blood pH; a raised base deficit reflects the metabolic acidosis of hypoperfusion and tracks shock severity.

Communication behaviours that shut down or avoid a patient's or family's emotion rather than acknowledging it.

The structured, empathic delivery of serious or unwelcome information, for which SPIKES provides a stepwise method.

Prognostic information matched honestly to the actual type and severity of the shock — neither falsely reassuring nor needlessly bleak.

The ability to understand, retain, weigh and communicate a decision; when absent, decisions are made with family/surrogates in the patient's best interests.

Shock from pump failure (e.g. myocardial infarction, arrhythmia); low cardiac output with congestion and high systemic vascular resistance.

An agreed limit on the intensity of treatment (e.g. whether to escalate to intensive care or resuscitate), decided through shared discussion.

Agreeing with relatives to withhold the truth from a patient who has capacity and wishes to know, in breach of the patient's autonomy.

The early phase in which the systolic blood pressure is maintained by compensatory tachycardia and vasoconstriction despite significant volume loss.

An isotonic balanced salt solution (e.g. Ringer's lactate) used as the initial fluid to restore circulating volume in shock.

A strategy combining permissive hypotension, balanced blood-product (haemostatic) transfusion and early source control while avoiding the lethal triad.

Shock from pathological vasodilatation with low systemic vascular resistance; includes septic, anaphylactic and neurogenic shock.

The deliberate acknowledgement and understanding of another person's emotional experience, demonstrated through words, attention and presence.

Offering unwarranted comfort ('he'll be fine') that misrepresents the prognosis and undermines trust — a recognised communication pitfall.

Shock from loss of circulating volume (haemorrhage, burns, fluid loss); low preload, low cardiac output and high compensatory systemic vascular resistance.

Overwhelming the listener with too much jargon-laden information at once instead of plain-language chunks with checks of understanding.

The self-reinforcing combination of hypothermia, acidosis and coagulopathy that drives mortality in major trauma and must be prevented during resuscitation.

Distributive shock from loss of sympathetic tone (e.g. spinal-cord injury) causing hypotension with paradoxical bradycardia and warm peripheries.

A set of empathic-response stems — Name, Understand, Respect, Support, Explore — used to acknowledge and respond to a patient's or family's emotion.

Shock from mechanical obstruction to cardiac filling or output, e.g. tension pneumothorax, cardiac tamponade, massive pulmonary embolism.

Deliberately accepting a lower target blood pressure (palpable radial pulse, systolic ~80–90 mmHg) in uncontrolled haemorrhage until the bleeding source is controlled.

The likely course and outcome of an illness; in shock it depends on the type, severity, organ involvement and speed of source control, and must be communicated honestly.

The difference between systolic and diastolic blood pressure; it narrows early in haemorrhagic shock as catecholamines raise the diastolic pressure.

Distributive shock due to the systemic inflammatory response to infection, with vasodilatation, hypotension persisting despite fluids, and raised lactate.

A marker of global tissue hypoperfusion and anaerobic metabolism; its clearance with treatment indicates effective resuscitation.

A state of inadequate tissue perfusion in which oxygen delivery fails to meet cellular demand, leading to anaerobic metabolism and organ dysfunction.

A six-step framework for breaking bad news: Setting up, Perception, Invitation, Knowledge, Emotions/empathy, and Strategy/Summary.

The NMC 'shows-how' competency requiring the graduate to communicate and counsel patients and families about the treatment and prognosis of shock with empathy and care.

Agreement to a treatment given voluntarily by a person with capacity who has been adequately informed of its nature, benefits and risks.

A brief preparatory statement ('I am afraid I have some serious news') that signals difficult information is coming and lets the listener brace for it.