Shock/Hypotension

Question 1

Shock S/S

Answer 1

• Cool/mottled or flushed/ruddy skin
• Hypotension for age
• ALOC
• Delayed capilary refill >2 sec
• Tachycardia out of proportion to temp
• Tachypnea
• Tarry stool/GI bleed

Question 2

If Pregnant..

Answer 2

Place in Left Lateral Recumbent Position

Question 3

First Line of TXs

Answer 3

• Lay flat/Trendelenburg position (Do not stand)
• 18g IV access x2 (Consider IO early)
• Cardiac Monitoring (3 or 12 lead)
• Fluids (Reassess after q 500mL)
• Push Dose Epi for Cardiogenic Shock/Pulmonary Edema

Question 4

Causes of Cardiogenic Shock

Answer 4

OD
Heart Failure
MI
Arrhythmias
Myocarditis

Question 5

If Due to Blood Loss?

Answer 5

Consider TXA if Shock Index Permits

Question 6

If due to Fluid Loss?

Answer 6

Consider Lactated Ringers

Question 7

If Unresponsive to Fluid Challenge?

Answer 7

Give Push Dose Epi

Question 8

If Pt has HX of Adrenal Insufficiency?

Answer 8

Assist w/ own Hydrocortisone

OR

Administer Solumedrol (2mg/kg, 125mg max)

Question 9

Hydrocortisone Dosage

Answer 9

Age: Dose

> 12: 100mg

3-12: 50mg

0-3: 25mg