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Shock - Differential Diagnosis by Classification

Hypovolemic (Intravascular volume depletion)
 - Hemorrhagic 
   • Trauma
Shock - Differential ... a.k.a. neurogenic shock ... - Severe heart failure ... Classification #Table ... #CriticalCare
American College of Critical Care Medicine algorithm for time-sensitive, goal-directed stepwise management of hemodynamic support in
American College of Critical ... Care Medicine algorithm ... Proceed to next ... #Shock #Algorithm ... #CriticalCare #
Shock Types and Classification
DISTRIBUTIVE 66%
 • Sepsis/SIRS, anaphylaxis, adrenal insufficiency, liver failure, toxins, spinal/neurogenic
 • Warm
Shock Types and ... insufficiency, liver failure ... CHF • Cold and Wet ... Cold and Dry #Shock ... #differential #criticalcare
Common Vasopressors and Inotropes
Norepinephrine (NE)
 - Indication: Distributive shock (1st line for septic shock), Cardiogenic shock
Norepinephrine (NE ... HR is not desired ... where ↑ HR is not ... Inotropes #comparison #table ... #pharmacology #criticalcare
Shock Overview
A state of tissue hypoxia due to decreased or dysregulated oxygen delivery or extraction, resulting
-> multiorgan failure ... death Common Clinical ... thyroid dz liver failure ... • MI, Heart Failure ... management #Overview #criticalcare
Vasopressors and Inotropes
 • Norepinephrine - Levophed - "Levo" - Generally thought of as the first
pressor added in shock ... Neosynephrine - "Neo ... . so generally not ... Inotropes #management #criticalcare ... summary #comparison #table
Shock Overview
A state of tissue hypoxia due to decreased or dysregulated oxygen delivery or extraction, resulting
-> multiorgan failure ... death Common Clinical ... thyroid dz liver failure ... • MI, Heart Failure ... management #Overview #criticalcare
Shock - Differential Diagnosis Framework
MAP = CO x SVR
Hypovolemic (↓ Intravascular volume):
 • Hemorrhage, dehydration due
Shock - Differential ... • Severe heart failure ... uw_IMresidency #Shock ... Differential #Diagnosis #table ... #comparison #criticalcare
Approach to Undifferentiated Shock - OnePager Summary
Shock occurs when there is inadequate blood flow (CO) &
protean and may not ... (PE, PHTN), LV Failure ... Obstruction (HOCM, critical ... anesthesia), Liver Failure ... guyton #curves #criticalcare
Pediatric SVT - Management Algorithm
Identify SVT:
 • HR not variable
 • Abrupt rate changes
 • Infants:
SVT - Management Algorithm ... Monitors, Pads AP Stable ... Signs of shock or ... heart failure ... tachycardia #Management #Algorithm