EM Fundamentals

APPROACH TO SHOCK

Goals and Objectives Goals Resident will be comfortable with initial evaluation and basic management of patients with shock   Learning Objectives Resident will be able to list the four categories of shock and common etiologies for each category Hypovolemic Blood loss Dehydration Cardiogenic Arrhythmia ACS Heart Failure Valvular Disease Distributive Sepsis Neurogenic Anaphylaxis Endocrine Obstructive Pulmonary Embolism Tension Pneumothorax Cardiac Tamponade Resident will describe history and physical exam findings to support diagnosis of shock etiology Resident will describe basic management of patients in each category of shock

Recommended Resources Prior to Conference Four Types of Shock (EM in 5)   Additional Resources Approach/Review Approach to Shock (CDEM) Choosing the right vasopressor agent in hypotension (ALIEM) PV Card: Vasopressors and Inotropes for Shock (ALIEM) The rational clinical examination. Is this patient hypovolemic? (JAMA) Cardiogenic Shock Cardiogenic Shock (EMCrit) Crashing AFib Patient (EMCrit) Septic Shock See: Sepsis Neurogenic Shock Neurogenic Shock (Open Ped Med J 2013) Hemorrhagic Shock Hemorrhagic Shock Resuscitation (EMCrit) Anaphylactic Shock Allergy and Anaphylaxis (EB Medicine 2015) Pulmonary Embolism PE Treatment Options (EMCrit) Tension Pneumothorax Pneumothorax: From Definition to Diagnosis and Treatment (J Thorac Dis 2014) (pdf) Pneumothorax and Asthma (J Thorac Dis 2014) (pdf) Needle Decompression for Tension Pneumothorax (EPMonthly) Cardiac Tamponade Acute Cardiac Tamponade (NEJM 2003) Cardiac Tamponade Revisited (Tex Health Inst 2007) Emergency Pericardiocentesis (NEJM) Ultrasound in Shock RUSH Exam (ALIEM) RUSH Exam (EMCrit) IVC for Decisions on Fluid Status (EMCrit)

Original Post by Eric Shappell on 12/01/2014
Reviewed by James Ahn on 12/01/2014
Last Updated by Eric Shappell on 02/16/2016 Contact / Feedback