This chapter targets to provide information to medical students, residents, and nurses on emergency medicine. The concept and definitions of shock have been mentioned. An overview about shock has been given at the beginning of the chapter. Different categories of shock have been elaborated with comparison. Each type of shock has been discussed with its specificities and its management. Septic shock has been extensively discussed and different definitions and terminology have been used. Latest surviving sepsis campaign guidelines have been scribbled down. Hemorrhagic shock has been widely discussed too and a table provided for the differentiation of stages of hemorrhagic shock. Finally, the chapter is concluded with all the references used for accomplishing this chapter.

Urinary diversion, a surgical technique to redirect urine usually after cystectomy, and its complications are potential challenges to physicians and early recognition decreases mortality and morbidity. A 45-year-old male with a history of type 2 diabetes mellitus and hypertension for over three years underwent urinary diversion as a treatment for invasive bladder cancer and was discharged ambulatory with an indwelling Foleys catheter. The patient returned to the emergency room with a primary complaint of hematuria. The patient was noted to be frail-looking, dehydrated and tachycardic. Laboratory results yielded an acute kidney injury reflected by the elevated creatinine, hyperkalemia and a venous blood gas demonstrating a hyperchloremic metabolic acidosis. The patient had bilateral distended renal calyces by ultrasound and irrigation of bladder through a three-way Foley showed to have large thick clots. The patient was admitted under the surgical intensive care unit after involving appropriate sub-specialties. The patient was started on sodium bicarbonate infusion, broad-spectrum antibiotics and a urinary catheter in place to monitor urine output. The patient's acidosis steadily improved with correction of his laboratory parameters, transferred out of ICU and the remaining stay in the medical ward was uneventful. The purpose of this case report is to help demonstrate the association between urinary diversion and the type of acidosis that subsequently develops in relation to this surgical procedure.

Adult intussusception is a challenging disease that occurs infrequently, and differs in presentation, etiology, and management from childhood intussusception. In fact, it accounts only for just 5% of all intussusceptions with approximately 1% of cases causing intestinal obstruction. The diagnosis in adults is often delayed as symptoms are non-specific and of intermittent nature. When present, these symptoms may include abdominal pain as well as nausea and vomiting. This article focuses on the importance of considering the diagnosis of intussusception in adult patients with relatively uncommon presentations such as hematochezia.