Circulation (Shock)

Summary: <br> Tank. Clogged Pipes. Broken Pipes. Pump.<br> <br> <br> <br> Introduction<br> <br> <br> <br> * “Tank”* Hypovolemic shock* Hemorrhagic shock* “Clogged Pipes”* Cardiac tamponade* Tension pneumothorax* Pulmonary embolism* “Broken Pipes”* Septic Shock* Neurogenic Shock* Anaphylactic Shock* “Pump”* Cardiogenic Shock<br> <br> <br> <br> Step 1: Fill the Tank<br> <br> <br> <br> * Establish an IV* IO line alternative in emergent situations<br> <br> <br> <br> Step 2: Consider Clogs<br> <br> <br> <br> * Cardiac tamponade* Diagnosis: Ultrasound* Treatment: Pericardiocentesis* Tension pneumothorax* Diagnosis: Clinical/Xray/Ultrasound* Treatment: Needle decompression and tube thoracostomy* Pulmonary embolism* Diagnosis: Clinical/CTA* Treatment: Thrombolytics<br> <br> <br> <br> Step 3: Squeeze the Pipes<br> <br> <br> <br> * Administer vasopressors* Most common: Norepinephrine* Alternatives: Epinephrine, Phenylepherine<br> <br> <br> <br> Step 4: Analyze the Pump<br> <br> <br> <br> * Get an EKG* Ischemia = Aspirin/Heparin/Cath lab* Dysrhythmia = Electricity<br> <br> <br> <br> Additional Reading<br> <br> <br> <br> * Airway Part 1 – Immediate Actions <a href="http://www.emclerkship.com/airway/">(EM Clerkship)</a>* Breathing <a href="http://www.emclerkship.com/airway/">(EM Clerkship)</a>* RUSH Exam <a href="https://emcrit.org/rush-exam/">(EMCrit)</a><br>