Hypovolaemic
- Cold periphery, low JVP
- Crystalloid → blood; control bleeding
- PRBC:FFP:Plt 1:1:1, TXA within 3 h
Cardiogenic
- Cold + congested, raised JVP
- Cautious fluids 250 mL
- Inotrope: dobutamine ± noradrenaline
- PPCI for STEMI; IABP / IMPELLA
Distributive (sepsis/anaphylaxis)
- Warm initially, low SVR
- Fluid 30 mL/kg + antibiotics ≤1 h (sepsis)
- Noradrenaline if MAP <65
- IM adrenaline 0.5 mg in anaphylaxis
Obstructive
- Distended neck veins + low BP
- Decompress pneumo / drain tamponade / thrombolyse PE
