From the Guidelines
The mnemonic "SHOCK" is the most helpful tool to remember the main symptoms of septic shock, which stands for Skin changes, Hypotension, Oliguria, Confusion, and Kardiac abnormalities. This mnemonic is crucial in quickly identifying patients who may be experiencing septic shock, a condition that requires immediate medical attention to prevent high morbidity and mortality. According to the Surviving Sepsis Campaign guidelines 1, septic shock is defined as sepsis with persistent hypotension despite adequate fluid resuscitation, and it is associated with perfusion abnormalities such as lactic acidosis, oliguria, or altered mental status. The "SHOCK" mnemonic helps clinicians to rapidly assess patients for these critical symptoms, which include skin changes (mottled, cold extremities), hypotension (systolic blood pressure <90 mmHg), oliguria (decreased urine output), confusion (altered mental status), and kardiac abnormalities (tachycardia, decreased cardiac output). Early recognition of these symptoms is vital, as septic shock requires prompt intervention with IV fluids, broad-spectrum antibiotics, and vasopressors if necessary, to restore adequate blood pressure and prevent organ dysfunction, as emphasized in the guidelines 1 and further explained in the context of sepsis and septic shock 1.
Some key points to consider when assessing a patient for septic shock include:
- The presence of a suspected or confirmed infection source
- The patient's hemodynamic status, including blood pressure, heart rate, and urine output
- The presence of organ dysfunction, such as respiratory distress, altered mental status, or decreased urine output
- The need for immediate intervention with IV fluids, broad-spectrum antibiotics, and vasopressors if necessary, as recommended by the guidelines 1.
By using the "SHOCK" mnemonic and considering these key points, clinicians can quickly identify patients who may be experiencing septic shock and provide timely and effective treatment to improve outcomes.
From the Research
Main Symptoms of Septic Shock
The main symptoms of septic shock can be remembered using the mnemonic: SHOCK
- S: Systolic blood pressure ≤90 mm Hg or mean arterial blood pressure ≤65 mm Hg 2
- H: Hypoperfusion (eg, oliguria, hyperlactemia, poor peripheral perfusion, or altered mental status) 2
- O: Organ dysfunction (e.g., cardiac, renal, or respiratory failure)
- C: Clinical signs of infection (e.g., fever, tachycardia, tachypnea) 3
- K: Known or suspected source of infection
Additional Symptoms
Other symptoms of septic shock may include: