Shock - Diagnosis and Management Summary
 • Hypotension: ...
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Shock - Diagnosis and Management Summary

 • Hypotension: SBP<90, SBP drop >40, MAP<65 (Normotension, HTN possible w/ early shock state)

 • Tachycardia > 100 BPM

 • Oliguria

 • Altered Mental Status (SBP<60)

 • Elevated lactate

 • qSOFA/SOFA and SIRS

1) Prepare

 • Full Set of Vital Signs

 • Establish IV/IO Access - 2-large bore (18-gauge) peripheral IV's, Consider IL NS/LR infusion

 • Room Setup

     - Ultrasound, code cart in rom

     - Patient on monitor, telemetry, 12-Lead EKG

 • Ensure adequate support

     - Call appropriate code

     - Notify Seniors

2) Readily Reversibles

3) Stabilize and Survey

4) Workup

5) Analyze and Reverse

 • Obstructive Shock

     - Distended neck veins, dilated IVC

     - Cardiac >> Constrictive pericarditis, Pericardial Tamponade

     - Pulmonary >> Acute PE, Tension Pneumothorax

 • Hypovolemic Shock

     - Dry, Flat, collapsible IVC

     - Hemorrhagic >> Transfuse to Hgb>7

     - Non-hemorrhagic >> Aggressive volume resuscitation

 • Cardiogenic Shock

     - MI, arrhythmia, valvulopathy

     - Diffuse crackles, elevated JVP, echo abnormalities

     - Cath lab? Terminate arrhythmia? Cardiac surgery?

 • Distributive Shock

     - Septic Aggressive IVF , ABX

     - Anaphylactic >> IM Epinephrine

     - Neurogenic >> Vasopressors, Inotropes

     - Adrenal Insufficiency >> Corticosteroids



Dr. Michael Jones @Jonesy_MA



#Shock #Diagnosis #Management #Summary #criticalcare #treatment #workup
Contributed by

Dr. Gerald Diaz
@GeraldMD
Board Certified Internal Medicine Hospitalist, GrepMed Editor in Chief 🇵🇭 🇺🇸 - Sign up for an account to like, bookmark and upload images to contribute to our community platform. Follow us on IG:  https://www.instagram.com/grepmed/ | Twitter: https://twitter.com/grepmeded/
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