RNCHAMPS

RNCHAMPS (pronounced "R, N, champs") is a mnemonic acronym used to recall the types of shock. The mnemonic is alternately known as CRAMPS NH ("Cramps, New Hampshire") or NH-CRAMPS ("New Hampshire cramps").^[1] Its utility in distinguishing types of shock has been discussed in medical literature and reference material concerning emergency medicine,^[1] emergency medical services,^[2] fire rescue,^[3] and specialized courses such as the Comprehensive Advanced Life Support Program.^[4]

The acronym

	Component of acronym	Examples: Traumatic Causes	Examples: Medical Causes
R	Respiratory	Flail chest; tension pneumothorax; pleural effusion^[2]	Hypoxemia due to COPD, asthma, pulmonary edema^[2]
N	Neurogenic	Traumatic brain injury; cervical or high thoracic spinal cord injury
C	Cardiogenic	Cardiac tamponade; tension pneumothorax; pulmonary embolism^[5]	Left ventricular myocardial infarction; cardiomyopathy; bradydysrhythmias^[5]^[6]
H	Hypovolemic	Hemorrhage; burns (due to third spacing)^[6]	Dehydration; diarrheal diseases; aortic aneurysm^[6]
A	Anaphylactic		Anaphylaxis^[7]
M	Metabolic	Hypoventilation due to traumatic brain injury or tension pneumothorax^[8]	Diabetic ketoacidosis; hypoventilation due to COPD, asthma, or severe pneumonia^[8]
P	Psychogenic		Sudden emotional stimulus, i.e. terror, elation, or surprise^[6]
S	Septic	Osteomyelitis; infections secondary to burns^[9]	Meningitis; bacteremia; pyelonephritis; upper respiratory infection^[9]

Alternatives

The Comprehensive Advanced Life Support (CALS) Program uses a slightly different acronym called "SHRIMPCAN."^[4] This acronym adds the letter "I", which stands for "Ingestions" (drug overdoses). The remainder of the letters in the acronym stand for the same components as the RNCHAMPS mnemonic.^[4]

References

^ ^a ^b Emergency: Volume 28, Issues 7-12. Bobit Publishing Company. 1996. p. 28.
^ ^a ^b ^c Mistovich, Joseph J.; Karren, Keith J.; Hafen, Brent (July 18, 2013). Prehospital Emergency Care (10th ed.). Prentice Hall. ISBN 978-0133369137.
^ Roosevelt, Jason (July 3, 2008). "Mobility and Movement: Shock". Phoenix Fire Department. p. 197.
^ ^a ^b ^c Comprehensive Advanced Life Support Provider Manual. Vol. 3rd (14th ed.). Comprehensive Advanced Life Support Program. January 2016. p. 693. Retrieved February 1, 2016.
^ ^a ^b Harjola VP, Lassus J 2015; et al. (2015). "Clinical picture and risk prediction of short-term mortality in cardiogenic shock" (PDF). European Journal of Heart Failure. 17 (5): 501–509. doi:10.1002/ejhf.260. hdl:11573/910722. PMID 25820680. S2CID 39258741.{{cite journal}}: CS1 maint: numeric names: authors list (link)
^ ^a ^b ^c ^d Snyder, Ed; Walker, Melanie. "Shock" (PDF). Huntington Memorial Hospital. Retrieved February 1, 2016.
^ Kounis NG, Soufras GD, et al. (2013). "Anaphylactic Shock: Kounis Hypersensitivity-Associated Syndrome Seems to be the Primary Cause". North American Journal of Medical Sciences. 5 (11). United States National Library of Medicine, National Institutes of Health: 631–636. doi:10.4103/1947-2714.122304. PMC 3877435. PMID 24404540.
^ ^a ^b Vincent J-L; De Backer D 2013 (2013). "Circulatory Shock" (PDF). New England Journal of Medicine. 369 (18): 1726–1734. doi:10.1056/NEJMra1208943. PMID 24171518. S2CID 6900105. Archived from the original (PDF) on 2019-02-23.{{cite journal}}: CS1 maint: multiple names: authors list (link) CS1 maint: numeric names: authors list (link)
^ ^a ^b Angus DC; van der Poll, T 2013 (Aug 2013). "Severe Sepsis and Septic Shock". New England Journal of Medicine. 369 (9): 840–851. doi:10.1056/NEJMra1208623. PMID 23984731.{{cite journal}}: CS1 maint: multiple names: authors list (link) CS1 maint: numeric names: authors list (link)