Shock is one of the most frequently diagnosed, yet poorly understood disorders in the pediatric intensive care
unit (PICU). The very definition of what constellation of physical signs and symptoms that comprise shock remains
controversial, in part due to the vast array of disorders that cause shock in critically ill and injured children. Early
management and reversal of the shock state is associated with significantly improved outcomes. However, early
management is critically dependent upon the early recognition and diagnosis of shock at the bedside. Failure to recognize
the signs and symptoms of shock and to institute timely and appropriate care leads to higher mortality rates in both
children and adults. Clinical recognition of shock requires a high index of suspicion – as such, all pediatric health care
providers should be cognizant of the clinical presentation, pathophysiology, and early management of shock.