Undifferentiated shock: Difference between revisions
(Created page with "==Definition== SBP <90 in nl pt SBP<100 with h/o HTN or age >60 ABG = lactate > 4 or base def < -4 MAP = SVR x CO ==Types == Type Skin HR Oth Hypovolemic cold inc...") |
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MAP = SVR x CO | MAP = SVR x CO | ||
==Types == | ==Types == | ||
Type Skin HR Oth | Type Skin HR Oth | ||
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**PE: no response to IVF, nmlly hypoxic if large enough to cause shock | **PE: no response to IVF, nmlly hypoxic if large enough to cause shock | ||
==Undifferentiated Hypotension Algorithm (Morchi== | |||
Check: | Check: | ||
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Pace or Shock | Pace or Shock | ||
2) Volume Status - LVEDP (approx by CVP, IVC, etc.) | 2) Volume Status - LVEDP (approx by CVP, IVC, etc.) | ||
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Hemeacuu, Guaic | Hemeacuu, Guaic | ||
3) Contractility (weak heart) | 3) Contractility (weak heart) | ||
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Cardiac Ultrasound | Cardiac Ultrasound | ||
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expect bounding pulse | expect bounding pulse | ||
Adapted from Morchi | Adapted from Morchi | ||
==Lack of Response to Normal Tx (DDX) == | ==Lack of Response to Normal Tx (DDX) == | ||
1) Cardiac tamponade | 1) Cardiac tamponade | ||
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8) DIC | 8) DIC | ||
==Source == | ==Source == | ||
2/06 DONALDSON (Adapted from Tintinalli) | 2/06 DONALDSON (Adapted from Tintinalli) | ||
Morchi 2010 | Morchi 2010 | ||
[[Category:Airway/Resus]] | [[Category:Airway/Resus]] | ||
Revision as of 08:38, 2 March 2011
Definition
SBP <90 in nl pt
SBP<100 with h/o HTN or age >60
ABG = lactate > 4 or base def < -4
MAP = SVR x CO
Types
Type Skin HR Oth Hypovolemic cold inc Obstructive cold inc ** Cardiogenic cold inc/dec ?dysth Anaphylactic warm inc hives Neurogenic warm dec
- PE: no response to IVF, nmlly hypoxic if large enough to cause shock
Undifferentiated Hypotension Algorithm (Morchi
Check:
1) HR (age appropriate)
<40 and >150-180 --> likely HR = Primary etiology
Pace or Shock
2) Volume Status - LVEDP (approx by CVP, IVC, etc.)
History of volume loss
Lung Exam
Mucous membrane
Ultrasound IVC (RUQ window or AAA)
Hemeacuu, Guaic
3) Contractility (weak heart)
Bounding/thready pulse, hyperdynamic precordium
Cardiac Ultrasound
4) Low SVR - Vasodilation is the final answer, if all else is negative
expect bounding pulse
Adapted from Morchi
Lack of Response to Normal Tx (DDX)
1) Cardiac tamponade
2) Tension PNTX
3) Adrenal insuffic
4) Toxin
5) Allergic Rx
6) Occult bleeding (ectopic, A/P)
7) PE
8) DIC
Source
2/06 DONALDSON (Adapted from Tintinalli)
Morchi 2010