REBEL Cast

REBEL Core Cast 138.0: A Simple Bedside Approach to Shock

Aug 4, 2025
Discover the intriguing nature of shock as a clinical diagnosis, emphasizing that it's more than just a number. Learn to assess patients rapidly using the 'four L's' — mental status, limb temperature, urine output, and lactate levels. Find out how pulse pressure can reveal shock type, from narrow pressures indicating cardiogenic issues to wide pressures pointing towards distributive shock. The hosts stress the importance of systematic bedside evaluation, reinforcing that even basic techniques can uncover critical insights.
Ask episode
AI Snips
Chapters
Transcript
Episode notes
ADVICE

Four L's Bedside Assessment

  • Use the Four L's at the bedside: Lucid (mental status), Limbs (warm/cold), Leak (urine output), Lactate.
  • This quick assessment helps determine if a patient with low blood pressure is truly in shock or compensated and appearing well.
INSIGHT

Pulse Pressure Explains Shock Types

  • Systolic BP reflects stroke volume while diastolic BP reflects systemic vascular resistance.
  • Pulse pressure (systolic minus diastolic BP) helps differentiate shock types based on stroke volume and vascular tone changes.
INSIGHT

Narrow Pulse Pressure Means Cold Shock

  • Narrow pulse pressure indicates low stroke volume with compensatory increased systemic vascular resistance.
  • This pattern occurs in cardiogenic, hypovolemic, and obstructive shock, commonly described as cold shock.
Get the Snipd Podcast app to discover more snips from this episode
Get the app