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Shock Classification and Differential Diagnosis SHOCK • MAP <65, SBP <90, drop in SBP > 40 •
Shock Classification ... Differential Diagnosis SHOCK ... Distributive: • High CO ... Cardiogenic: • Low CO ... Sophia_Hayes_MD #Shock
Decision tree of FALLS-protocol (Fluid Administration Limited by Lung Sonography). Lung Ultrasound in the hemodynamic assessment
assessment of Shock ... then distributive shock ... , i.e. septic shock ... #CriticalCare #Shock ... #Fluids #POCUS
Shock - Differential Diagnosis Framework MAP = CO x SVR Hypovolemic (↓ Intravascular volume): • Hemorrhage, dehydration due
Shock - Differential ... Framework MAP = CO ... third-spacing • ↓ CO ... arrhythmia • ↓ CO ... uw_IMresidency #Shock
Approach to Undifferentiated Shock - OnePager Summary Shock occurs when there is inadequate blood flow (CO) &
Undifferentiated Shock ... OnePager Summary Shock ... inadequate blood flow (CO ... Pump Problem (↓ CO ... may develop low CO
Shock - Differential Diagnosis Framework - MAP <65. SBP <90, drop in SBP > 40 -
Shock - Differential ... Lactate > 1.5 High CO ... Cord Injury Low CO ... Dehydration Shock ... Sophia_Hayes_MD #Shock
POCUS - Measuring Cardiac Output 1) Calculate LVOT Area 2) Calculate LVOT VTI 3) Calculate Cardiac Output SV = (LVOT
POCUS - Measuring ... ) x (LVOT VTI) CO ... LVOT VTI) X HR CO ... x HR (bpm) - POCUS ... Cardiac #Output #CO
Shock Overview A state of tissue hypoxia due to decreased or dysregulated oxygen delivery or extraction, resulting
Shock Overview ... of hypotension Shock ... - Low CO and therefore ... - Low CO and therefore ... - Low CO and therefore
Vasopressors and Inotropes - Pharmacology Summary Vasopressors Phenylephrine (alpha-1) • Increases BP, SVR • Risk of reflex bradycardia
Increases BP, SVR, CO ... first agent in shock ... Increases HR, SVR, CO ... line in septic shock ... contractility, CO
Shock Overview A state of tissue hypoxia due to decreased or dysregulated oxygen delivery or extraction, resulting
Shock Overview ... of hypotension Shock ... - Low CO and therefore ... - Low CO and therefore ... - Low CO and therefore
Common Vasopressors and Inotropes Norepinephrine (NE) - Indication: Distributive shock (1st line for septic shock), Cardiogenic shock
: Distributive shock ... line for septic shock ... ), Cardiogenic shock ... (mild ↑CO) - Side ... , Shock where ↑
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