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THE MECHANISM AND MANAGEMENT OF SURGICAL SHOCK

DALLAS B. PHEMISTER, M.D.
JAMA. 1945;127(17):1109-1112. doi:10.1001/jama.1945.02860170021005.
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Surgical shock is the term commonly used to denote the acute embarrassment or failure of the circulation which arises as a result of bodily injury, whether produced intentionally, in combat and in surgical operations, or unintentionally in accidents of civil life.

There has been a great deal of debate about the mechanism of production of shock and about the relative role of various factors which may help in bringing it about, but in recent years it has been established primarily by the surgeons that the overwhelmingly important cause of surgical shock in man in good general condition prior to injury or operation is local loss of whole blood or plasma, or a combination of the two, from the circulation, thereby reducing the circulatory blood volume. If this reduction is sufficiently pronounced and prolonged, the blood pressure drops to a low level, anoxia develops, the tissues are damaged, there is generalized

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