Shock
Recognise impaired perfusion and compare the possible causes before discussing treatment.
Clinical learning outcomes: Awaiting named clinical review.
What you should learn
- Identify signs of shock and call for help promptly.
- Relate initial treatment and reassessment to the likely cause.
Recognise and explain
- Compare hypovolaemic, cardiogenic, distributive and obstructive causes; low blood pressure alone is not the whole assessment.
On your placement
Agree the activity and supervision with the clinical team. For patient-facing learning, seek permission and respect the patient’s comfort and care needs.
- Assess observations, perfusion and mental state with a clinician.
- Review an ECG and blood gas alongside the examination.
- Discuss the indication for fluids or blood and how the response will be reassessed.
Observe and understand
- Observe major-haemorrhage activation and specialist use of vasopressors or inotropes.
Observation does not establish competence to perform these activities.
The discussion lesson uses upper gastrointestinal bleeding as one example of haemorrhagic shock.
Start here
MLA: assess, act and reassess
Use assessment, initial action and reassessment as the framework for an unwell patient.
Current guidance
NICE CG174: IV fluids in adults
Use the adult assessment and reassessment sections to discuss why fluids are needed and how their effect will be checked.
NICE: shock after major trauma
If injury and haemorrhage are suspected, read the initial assessment and bleeding sections with the trauma team.
NICE: shock with suspected sepsis in adults
If infection is suspected, use the adult risk and early-management sections; pregnancy and younger children have separate pathways.
Discuss
Initial assessment of upper gastrointestinal bleeding
Contrast a shocked patient with a stable low-risk presentation to practise resuscitation, escalation and reliable follow-up.
On your next shift
Explain which observations showed improvement or deterioration after an intervention.
How this relates to GMC graduate outcomes and the MLA
These are St Emlyn’s learning connections, not a claim that this page covers every national requirement.
Presentations and conditions: Deteriorating patient; Haemorrhage.
Clinical and professional capabilities: Assessment and clinical reasoning; Recognising limits and seeking help.
St Emlyn’s interpretation of relevant GMC graduate outcomes and MLA themes; these are summary labels, not official topic codes or a complete curriculum.
Explore the student placement programme
Student practice and graduate expectations
About this resource and its review
A St Emlyn’s guide to learning Emergency Medicine during undergraduate placements. It is not an official medical-school or GMC curriculum. Your medical school’s curriculum and assessment requirements take precedence.
National foundations: GMC Outcomes for Graduates, the practical-skills supplement and the MLA content map applying from September 2026.
Framework checked: 8 October 2026. This is a source check, not clinical sign-off.
Clinical learning outcomes: awaiting named clinical review.
The four learning routes are St Emlyn’s groupings. The six interconnected MLA domains remain part of the official content map.