Shock is an important clinical condition presenting to the emergency department. Pathophysiology of septic, cardiogenic, hemorrhagic, obstructive, and anaphylactic shock are different however clinical assessment tools are the same and limited. It is important to identify shock in its early phase or the patient at risk of shock in the emergency department. There is no accurate clinical tool to identify the early stage of shock. Moreover, it is also important to assess fluid responsiveness to shock, available clinical and biochemical parameters respond differently to fluid resuscitation and none of the tools had 100% sensitivity and specificity. Therefore, this article reviews the available clinical and biochemical parameters to assess and monitoring fluid responsiveness in shock.

Background The services rendered by hospitals during the pandemic may not be efficient. This might impact the satisfaction of patients seeking healthcare. The aim of this study is to assess the satisfaction level of patients other than those with COVID-19 during the pandemic with different services provided by the hospital. Method A quantitative, analytical and cross-sectional study was carried out in a multidisciplinary hospital. Valid questionnaire, derived from PSQ III and PSQ 18, was used for data collection from 250 outpatients. Ethical approval was obtained. Systematic random sampling was done to enrol patients into the study after taking their consent. Descriptive analysis was performed using frequency, proportion, median and inter-quartile range. Mann–Whitney U test and Kruskal–Wallis test were carried out to find the association between overall satisfaction and different socio-demographic and other variables. Statistical significance was set at p-value < 0.05. Result Almost two-thirds of the respondents visiting the hospital during the pandemic were female (male: 35.6% and female: 64.4%). More than half (50.4%) of the patients reported that access to the hospital was feasible. Of the patients reporting dissatisfaction, most of them (86.4%) considered the establishment of separate COVID-19 hospitals as the best option. The median satisfaction score for the overall satisfaction of patients towards different service domains was 54.0 (45–60). Almost all respondents (95.6%) found that services were easily available. Patient satisfaction score was significantly associated with expenditure ( p < 0.001). Satisfaction score was also significantly associated with the time spent in the hospital by the patients ( p < 0.001). Conclusion Majority of the patients reporting to the multidisciplinary hospital were satisfied with the provisioning of treatment and different services during the COVID-19 pandemic. Relatively lesser satisfaction was reported for the provision of maintenance of social distance, availability of hand washing/sanitisation, overall hospital cleanliness and cost of treatment. Moreover, satisfaction among patients was associated with their perceived fear of the pandemic.