Sandbox/00002: Difference between revisions

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Revision as of 00:48, 8 April 2014

Symptoms & Signs

❑ Altered mental status
❑ Clammy skin ± cyanosis
❑ Hypotension (MAP <70 mmHg)
❑ Oliguria (urine output <0.5 mL/kg/h)

❑ Tachycardia (heart rate >100 bpm)

Shock

Ventilate

❑ Intubation with mechanical ventilation

Infuse

❑ Normal saline 500–1000 mL q10–15 minutes^†

Pump

❑ Norepinephrine 0.1–2.0 μg/kg/min

Workups

❑ 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

^† For septic and hypovolemic shock; consider normal saline 100—200 mL boluses for cardiogenic shock.

@@ Line 18: / Line 18: @@
 <center>'''Infuse'''</center>
 ----
-❑ Normal saline 500–1000 mL every 10–15 minutes (for septic and hypovolemic shock)<br>
+❑ Normal saline 500–1000 mL q10–15 minutes<sup>†</sup><br>
-❑ Normal saline 100–200 mL boluses (for cardiogenic shock)<br>
 <center>'''Pump'''</center>
 ----
@@ Line 27: / Line 26: @@
 <center>'''Workups'''</center>
 ----
 ❑ CBC/DC/SMA-7/PT/PTT<br>
 ❑ Arterial blood gas<br>
@@ Line 36: / Line 34: @@
 ❑ CXR<br>
 ❑ Central venous catheter<br>
-❑ Pulmonary artery catheter}}
+❑ Pulmonary artery catheter<br>}}
 {{Family tree|border=2|boxstyle=background: #FA8072; color: #F8F8FF; line-height: 10px; padding: 5px; text-align: left;                             | | | | | | | | | | | | | |!| | | | | | | | | | | | | | |}}
 {{Family tree|border=2|boxstyle=background: #FA8072; color: #F8F8FF; line-height: 20px; padding: 5px; text-align: left; height: 180px;              | | | | | | | | | | | | | B05 | | | | | | | | | | | | | |B05=
@@ Line 56: / Line 54: @@
+<sup>†</sup> For septic and hypovolemic shock; consider normal saline 100—200 mL boluses for cardiogenic shock.
 ==References==

Sandbox/00002: Difference between revisions

Revision as of 00:48, 8 April 2014

References

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