CanadiEM Podcasts: CRACKCast, ClerkCast, CarmsCast, First Year Diaries CRACKCast E197 – Shock
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Jan 7, 2019 Dive into the intricate world of shock management, revealing how circulatory shock can go unnoticed with normal blood pressure. Discover the various types of shock and their treatment strategies, emphasizing accurate diagnosis and early intervention. Learn to recognize signs of tissue hypoperfusion and the controversial concept of permissive hypotension in trauma care. Explore evolving approaches to sepsis management and the critical role of vasopressors in treatment. Finally, understand the importance of balanced resuscitation strategies in hemorrhagic shock for improved patient outcomes.
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Shock and Hypotension
- Circulatory shock can occur with normal blood pressure.
- Hypotension doesn't always indicate shock.
Lab Values in Shock
- A base deficit below -4 mEq/L or lactate above 4 mmol/L suggests shock.
- Use these values for presumptive diagnosis.
Urine Output Monitoring
- Monitor urine output as a vital organ perfusion index.
- Less than 0.5 ml/kg/hour indicates severe renal hypoperfusion.