Changes

==Special Considerations==

==Special Considerations==

===Shock===

===Shock===

'''Shock''' is defined as decreased oxygen delivery or utilisation by tissues that may lead to irreversible cellular damage if prolonged. Patients who present in a state of shock require immediate fluid therapy. To assess whether a patient is in shock the following signs may be seen -

'''[[Shock]]''' is defined as decreased oxygen delivery or utilisation by tissues that may lead to irreversible cellular damage if prolonged. Patients who present in a state of shock require immediate fluid therapy. To assess whether a patient is in shock the following signs may be seen -

*Tachycardia

*Tachycardia

*Pale mucous membranes (May be dark if distributive shock)

*Pale mucous membranes (May be dark if distributive shock)

The first choice fluid in hypovolemic shock cases are ''isotonic crystalloid'' fluids and are given at a high flow rate. They are often administered as a rapid bolus followed by the high flow rate. In cardiogenic shock cases, often the patient is already in volume overload and so often treated with a diuretic. Obstructive shock is often treated by removal of the obstruction.  

The first choice fluid in hypovolemic shock cases are ''isotonic crystalloid'' fluids and are given at a high flow rate. They are often administered as a rapid bolus followed by the high flow rate. In cardiogenic shock cases, often the patient is already in volume overload and so often treated with a diuretic. Obstructive shock is often treated by removal of the obstruction.

===Anaesthesia===

===Anaesthesia===