Approach to Shock

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🌱 來自: Huppert’s Notes

Approach to Shock🚧 施工中

Approach to Shock

•   Important formulas:

-   MAP = CO x SVR

-   MAP = (HR x SV) x SVR

MAP: Mean Arterial Pressure

CO: Cardiac Output

SVR: Systemic Vascular Resistance

HR: Heart Rate

SV: Stroke Volume

•   Initial evaluation of shock (regardless of etiology):

-   EXAMINE THE PATIENT (most important)

•   Are extremities warm (vasodilated) or cool (vasoconstricted)?

•   Assess volume status (JVP, POCUS, passive leg raise)

•   Is the blood pressure real? As a rule of thumb, if radial pulse is present, then SBP >90 mmHg

-   Check labs

•   CBC, CMP (BMP + LFTs), troponin, lactate, CVO2

-   Consider imaging and cardiac assessment

•   ECG, TTE, CXR; consider CT scans depending on the clinical concerns and hemodynamic trajectory

-   Consider infection

•   Blood cultures × 2, urinalysis with microscopy sputum culture or tracheal aspirate, sampling of other fluid (e.g., pleural, ascites fluid if indicated)