Shock - Differential Diagnosis Framework

 - MAP <65. SBP <90, drop in SBP > 40

 - End-organ malperfusion

 - Lactate > 1.5

High CO / Low SVR:

 • Distributive: Sepsis, Anaphylaxis, Adrenal Insufficiency, Liver Failure, Toxins/Medications, Spinal Cord Injury

Low CO / High SVR:

 • Cardiogenic: Myocardial Infarction, Decompensated CHF, Severe Valve Disease, Myocarditis, Arrhythmia

 • Obstructive: Pulmonary Embolism, Tension Pneumothorax, Cardiac Tamponade, Severe pHTN, Constrictive pericarditis, Severe auto-PEEP, Abdominal compartment syndrome, Vascular compression

 • Hypovolemic: Blood Loss, GI Losses, Third Spacing, Extreme Dehydration



Shock Treatment Goals:

1) MAP > 60-65

2) Lactate < 2.0

3) UOP > 0.5 cc/kg/hr



Sophia Hayes MD @Sophia_Hayes_MD



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