Emergency Medicine Board Bombs 256. Shock and Hypotensive? Do This FIRST
May 12, 2025
The hosts kick off with light-hearted tales, including puppy antics, before diving into the seriousness of managing hypotension. They explore urgent steps in treating low blood pressure, emphasizing norepinephrine's role and quick vital sign checks. A case study illustrates critical thinking under pressure, while rapid ultrasounds are highlighted for assessing cardiac function. Additionally, they discuss vital diagnostic strategies and the timing of interventions, blending humor with crucial medical insights.
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Start Norepinephrine Early
- For hypotension with no response to 1 liter fluid, start norepinephrine infusion immediately.
- This approach stabilizes blood pressure quickly in undifferentiated shock patients in the ED.
ABCDE Rapid Assessment
- Quickly assess airway, breathing, circulation, disability, exposure on hypotensive patients.
- Check mental status, capillary refill, pulses, and fully expose to find hidden causes.
Use RUSH Ultrasound Exam
- Use the RUSH exam with ultrasound to differentiate shock types rapidly.
- Check heart function, IVC collapsibility, free fluid, and lung signs to guide management.