SHOCK

Question 1

Clinical Shock

Answer 1

Clinical shock can be defined as a condition where tissue

oxygenation is inadequate for the needs of aerobic metabolism

Question 2

Endpoints of Resuscitation

Answer 2

• normal pH
• normal lactate
• CvO2 greater than or equal to 70%
• MvO2 greater than or equal to 65%
• CVP 8-12 mmHg
• MAP greater than or equal to 65 mmHg
• UOP greater than or equal to 0.5 mL/kg/hr

Question 3

Sepsis: What do I do if the patient isn’t responding to fluids?

Answer 3

Consider starting pressors. In sepsis, the first pressor is always Levophed. Start at 2 or 5 mcg/min, increasing by 2-5 mcg at a time. Max dose 30 mcg/min.

Can also check ionized calcium. If low, can give calcium gluconate to boost blood pressure.

Question 4

Levophed

Answer 4

In sepsis, the first pressor is always Levophed. Start at 2 or 5 mcg/min, increasing by 2-5 mcg at a time. Max dose 30 mcg/min.