Managing shock.

Shock is a clinical syndrome caused by a variety of primary insults, such as myocardial infarction, sepsis, and hypovolemia, which terminate in a failure of cellular perfusion. Management requires identification of the initial insult and the patient's hemodynamic pattern. The therapeutic approach in a patient may include resuscitation, fluid replacement, pH adjustment, and drug therapy. The specific treatment, however, must be tailored to fit the patient's individual problems and hemodynamic responses.