Shock may not be the commonest scenario encountered within the average clinical take, but unless rapidly recognised and managed appropriately, it carries an extremely high mortality. Shock is defined as inadequate tissue perfusion and is a consequence of a number of different clinical conditions. Hypotension is often, but not always, present. Blood pressure (BP) is a product of cardiac output (CO) and peripheral resistance (PR) as defined in the following equation: BP = CO x PR An inadequate cardiac output with intense vasoconstriction can therefore result in tissue hypoxia in the absence of hypotension. The recognition of shock, its causes and initial management will be discussed in this article. [download-attachments container="div" style="list" display_icon="1" display_count="1" display__size="0"]