Shock is a complex clinical syndrome involving a maldistribution of sy
stemic blood flow that results in inadequate delivery of oxygen and nu
trients to the tissues. Shock can be classified by cause or by functio
nal hemodynamic defect. The most important goal in treatment of shock
is to restore effective blood volume and optimize oxygen delivery. Agg
ressive intravenous or intraosseous fluid therapy is the cornerstone o
f therapy. Hypertonic saline and synthetic colloids may be useful as a
djunctive fluids in volume expansion and rapid reestablishment of circ
ulatory function. The use of glucocorticoid drugs remains controversia
l.