Stage 5: Decompensated Shock, Irreversible
Microvascular and organ damage are now irreversible (untreatable)
There is often a "last ditch" effort from the ischemic midbrain with an enormous discharge of endogenous catecholamines and this can create a last spike of sinus tachycardia (asterix*). We call stage 5 the "whoops! stage" --- too late to be able to turn things around.
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