Sandbox/0003

Symptoms & Signs ❑ Altered mental status ❑ Cyanosis ❑ Hypotension (MAP <60 mmHg) ❑ Oliguria (<0.5 mL/kg/h) ❑ Tachycardia ❑ Tachypnea

Shock

Resuscitation ❑ 0.5—1 L every 10—15 minutes† ❑ ± Morphine 2—4 mg boluses ❑ Ventilatory support Labs & Imaging ❑ CBC/DC/SMA-7/PT/PTT ❑ Arterial blood gas ❑ Lactate ❑ ECG ❑ CXR ❑ Echocardiography ❑ CXR ❑ Central venous catheter ❑ Pulmonary artery catheter Immediate Goals ❑ MAP >60—65 mmHg ❑ CVP 8—12 mmHg ❑ PCWP 12—15 mmHg ❑ CI >2.1 L/min/m2 ❑ Hemoglobin >7—9 g/dL ❑ SaO2 >90%—92% ❑ MVO2 >60% ❑ SCVO2 >70% ❑ Lactate <2.2 mM/L ❑ Urine output >0.5 mL/kg/h

^† 100—200 mL boluses for cardiogenic shock