Shock resident survival guide

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ahmed Zaghw, M.D. [2]

Causes

• Effective hypovolemia (distributive) where the vascular space increases but insufficient fluid is there to fill it.
  • Anaphylaxis
  • Neurogenic shock
  • Septic shock

Management

Shock

ABCD Airway / O2 / 2 wide bore IV access / 12-lead ECG / focused H&P / CXR

Volume defect

Pump defect

Heart Rate disturbances

Fluid/Blood products ± Vasopressors

Arrhythmia algorithm

SBP < 70 with cardiogenic shock

SBP 70-100 with cardiogenic shock

SBP 70-100 with no cardiogenic shock

Norepinephrine 1-30 μg/min

Dopamine 2–20 μg/kg/min

Dobutamine 2–20 μg/kg/min