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Vasopressors and Inotropes
 • Norepinephrine - Levophed - "Levo" - Generally thought of as the first
Vasopressors and ... Adrenalin - "Epi" - ACLS ... ), Symptomatic bradycardia ... - Symptomatic bradycardia ... comparison #table #pharmacology
Common Vasopressors and Inotropes
Norepinephrine (NE)
 - Indication: Distributive shock (1st line for septic shock), Cardiogenic shock
Common Vasopressors ... effects: Reflex bradycardia ... Can be used in all ... Cardiac ischemia #Vasopressors ... comparison #table #pharmacology
Vasopressors and Inotropes - Pharmacology Summary
Vasopressors
Phenylephrine (alpha-1)
 • Increases BP, SVR
 • Risk of reflex bradycardia
Inotropes - Pharmacology ... Risk of reflex bradycardia ... first agent in shock ... line in septic shock ... #Inotropes #Pharmacology
Clinical Management for Three Common Causes of Shock 
HEMORRHAGIC SHOCK
 • Ensure adequate ventilation and oxygenation.
HEMORRHAGIC SHOCK ... Ameliorate increased work ... • Begin vasopressor ... oxygenation; remove work ... , begin vasopressor
Shock - Diagnosis and Management Summary
 • Hypotension: SBP<90, SBP drop >40, MAP<65 (Normotension, HTN possible
Consider IL NS/LR infusion ... Setup - Ultrasound ... and Survey 4) Workup ... Neurogenic >> Vasopressors ... criticalcare #treatment #workup
Bradycardia - Differential Diagnosis Framework

BRADI Mnemonic
 • BRASH/Hyperkalemia
 • Reduced oxygen/Glucose/Temp
 • ACS
 • Drugs
 •
Bradycardia - Differential ... Glucose/Temp • ACS ... • Bradycardia ... blocking agent • Shock ... Sotalol • Propofol infusion
DETROIT CARDIOGENIC SHOCK INITIATIVE ALGORITHM

INCLUSION CRITERIA
Acute Myocardial Infarction
 Ischemic Symptoms
 EKG and/or biomarker evidence of AMI
DETROIT CARDIOGENIC SHOCK ... ) Cardiogenic Shock ... or the need for vasopressors ... visualization with use of ultrasound ... TIMI III flow in all
Severe Heart Failure & Cardiogenic Shock - Management Checklist 
Evaluation 
 - EKG & echocardiography
& Cardiogenic Shock ... edema - Large effusion ... nitroglycerine infusion ... (no B-lines on ultrasound ... NSAlDs, ACE-inhibitors
Intraoperative  Bradycardia - Guidelines for Crises in Anaesthesia
Bradycardia in theatre should not be treated as
Intraoperative Bradycardia ... in Anaesthesia Bradycardia ... reservoir bag and APL ... rate, rhythm, perfusion ... Diagnosis #Management #Workup
Pancreatitis management checklist 
Evaluation to guide etiology & management 
 - RUQ ultrasound 
 - Calcium
management - RUQ ultrasound ... as for septic shock ... amount fluid, vasopressors ... pain-dose ketamine infusion