31 results
Shock - Diagnosis and Management Summary
 • Hypotension: SBP<90, SBP drop >40, MAP<65 (Normotension, HTN possible
and Management ... and Survey 4) Workup ... - Pulmonary >> Acute ... Cardiac surgery? ... #Diagnosis #Management
Pericardial Tamponade in a Shock Patient

Watch how the heart collapses and struggles to beat in surrounding
Tamponade in a Shock ... how the heart collapses ... Clinical #POCUS #Echocardiogram ... #Cardiac #Tamponade
Bedside Classification of Shock

Hypovolemic shock 

- Vomiting, diarrhea, overdiuresis 

- Hemorrhage (GI, peritoneal, RP) 

Distributive shock
Classification of Shock ... Hypovolemic shock ... Anaphylaxis - Post-cardiac ... cardiomyopathy Acute ... Cardiogenic #Comparison #Table
Shock and Vasoactive Drugs 
1) Determine type and etiology of shock
 • Distributive: Sepsis, Anaphylaxis, Neurogenic
Shock and Vasoactive ... • Cardiogenic: Acute ... MI, Acute Heart ... inopressors #diagnosis #management ... #comparison #table
Shock Classification
Shock Definition: State of cellular and tissue hypoxia due to: reduced oxygen delivery, increased oxygen
infarction, following cardiac ... insufficiency, acute ... pneumothorax, cardiac ... Types #diagnosis #management ... warm #wet #dry #table
Pulse Abnormalities - Differential Diagnosis Algorithm
Unequal/DeIayed:
 • Obstructive arterial disease (ie. Atherosclerosis)
 • Aortic dissection
 •
pressure >10mmHg: • Cardiac ... tamponade • AECOPD/ Acute ... • Hypovolemic shock ... followed by rapid collapse
Myocarditis
Diagnosis 
• Endomyocardial biopsy (gold standard, rarely performed) 
• Clinical presentation 
• Cardiovascular MRI 
Clinical 
•
Abnormal ECG, echocardiogram ... • Cardiogenic shock ... , sudden cardiac ... death Management ... Myocarditis #Diagnosis #Management
Shock - Differential Diagnosis Framework
MAP = CO x SVR
Hypovolemic (↓ Intravascular volume):
 • Hemorrhage, dehydration due
Shock - Differential ... heart failure, acute ... → tension PTX, cardiac ... uw_IMresidency #Shock ... Differential #Diagnosis #table
Pulmonary Arterial Catheterization – Use and Interpretation:
-Pulmonary arterial catheterization (PAC) has never been shown to improve
or the type of shock ... severe cardiogenic shock ... (eg, acute valvular ... output (ie, cardiac ... #Differential #Table
DETROIT CARDIOGENIC SHOCK INITIATIVE ALGORITHM

INCLUSION CRITERIA
Acute Myocardial Infarction
 Ischemic Symptoms
 EKG and/or biomarker evidence of AMI
DETROIT CARDIOGENIC SHOCK ... INCLUSION CRITERIA Acute ... Fick calculated cardiac ... IF LVEDP >15 or Cardiac ... DCSI #Initiative #Management