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POCUS Algorithm for Chest Pain

Integrating POCUS in crashing chest pain is complex. Know the views that
Integrating POCUS in crashing ... narrowing the differential ... identify sick pts needing ... POCUS #Algorithm #CriticalCare ... #Shock #Crashing
Shock Types and Classification
DISTRIBUTIVE 66%
 • Sepsis/SIRS, anaphylaxis, adrenal insufficiency, liver failure, toxins, spinal/neurogenic
 • Warm
Shock Types and ... HYPOVOLEMIC 16% • Bleed ... (GIB, RP bleed) ... Classification #diagnosis #differential ... #criticalcare
Shock - Differential Diagnosis by Classification

Hypovolemic (Intravascular volume depletion)
 - Hemorrhagic 
   • Trauma
Shock - Differential ... Retroperitoneal bleed ... a.k.a. neurogenic shock ... #Differential # ... Classification #Table #CriticalCare
Shock Overview
A state of tissue hypoxia due to decreased or dysregulated oxygen delivery or extraction, resulting
• Hemorrhagic: bleeding ... , post-partum) bleeding ... RP bleed) • Hypovolemic ... management #Overview #criticalcare ... #differential #
Shock Overview
A state of tissue hypoxia due to decreased or dysregulated oxygen delivery or extraction, resulting
• Hemorrhagic: bleeding ... , post-partum) bleeding ... RP bleed) • Hypovolemic ... management #Overview #criticalcare ... #differential #
Shock - Differential Diagnosis Framework
 - MAP <65. SBP <90, drop in SBP > 40
 -
Shock - Differential ... Treatment Goals ... #Differential # ... Diagnosis #criticalcare ... #algorithm #treatment
Shock Types - Classification
State of cellular and tissue hypoxia due to: reduced oxygen delivery, increased oxygen
shock. ... Hemorrhagic → leading ... gastrointestinal bleeding ... diagnosis #management #criticalcare ... #differential
Occult Causes of Non-Response to Vasopressors

vital disclaimer: the cognitive response to hypotension should not be reaching
hypotension is treatment ... hypoCa2+ - occult bleeding ... - 2nd cause shock ... #Vasopressors #Differential
Approach to Undifferentiated Shock - OnePager Summary
Shock occurs when there is inadequate blood flow (CO) &
Undifferentiated Shock ... OnePager Summary Shock ... essential to determine treatment ... #diagnosis #differential ... guyton #curves #criticalcare
Pediatric Trauma Primary Survey: C-ABCDE
C - Catastrophic Bleeding - Life-threatening hemorrhage
 • Apply direct pressure/compression bandage
- Hemorrhagic shock ... a late sign of shock ... for more severe bleeds ... signs Neurogenic shock ... warm blankets, forced-air