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]