Cardiogenic Shock

Question 1

Sodium Chloride indication

Answer 1

Administer 0.9% sodium chloride IV if there are signs of poor perfusion, provided the patient has no signs or symptoms of pulmonary oedema and the primary problem is not dysrhythmia

Question 2

Sodium chloride dose

Answer 2

a) Administer 250-500 ml 0.9% sodium chloride IV.
b) This may be repeated as required, up to a maximum of 1 litre.
c) Stop the fluid if the patient develops signs or symptoms of pulmonary
oedema.

Question 3

DDx

Answer 3

MI - most common
PE
Dysrhythmia
Cardiac tamponade 
Myocarditis

Question 4

Cardiogenic shock secondary to poor left ventricular function

Answer 4

More common
Anterior, anteroseptal, anterolateral MI
Commonly associated with CPO
Unlikely to respond to NaCL

Question 5

Cardiogenic shock secondary to poor right ventricular function

Answer 5

Less common
MI involving the RV
Inferior MI - V4R
Shock is likely to respond to NaCl