Approach to Shock

by Carlo Raj, MD

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    00:01 there and the causes are going to help you do that.

    00:02 Approach. Shock needs to be treated rapidly. You don’t have time to mess around because you’re worried about end-organ dysfunction. Goal directed therapy is often what? To intubate early, to ensure adequate oxygenation. Often times, you’ll have to do that because who’s dying? The tissue, maybe the end-organ. You keep your central venous pressure above 8 with IV fluids. So, that’s important. When we talked about how your central venous pressure could be decreased, especially in septic or distributive type of shock, it’s important that you keep the heart properly pumping. Keep the mean arterial blood pressure at approximately 65 with the vasopressors such as, well, Alpha-1 agonists, right? Alpha-1 agonists, this once again, more or less dealing with your septic. Keep hematocrit approximately at 30 percent with transfusion, if need be, especially with your hypovolemic shock and use inotropic agents if your heart is failing, if it’s dealing with cardiogenic. So, if you’ve understood that table well, you can go through the approach to shock very quickly. You know exactly as to what your objective is in different types of shock on the previous table that you at this point, should be extremely comfortable with.

    About the Lecture

    The lecture Approach to Shock by Carlo Raj, MD is from the course Pulmonary Critical Care.

    Included Quiz Questions

    1. Intravenous fluid administration
    2. Early intubation for adequate oxygenation
    3. Vasopressor administration
    4. Diuretic therapy
    1. CVP > 8 mmHg
    2. CVP > 20 mmHg
    3. CVP > 2 mmHg
    4. CVP > 5 mmHg
    5. CVP > 3 mmHg
    1. Dobutamine
    2. Dopamine
    3. Atropine
    4. Digitalis
    1. Obstructive
    2. Cardiogenic
    3. Hypovolemic
    4. Neurogenic
    5. Septic
    1. < 7g/dL
    2. < 8 g/dL
    3. < 9 g/dL
    4. < 10 g/dL
    5. < 12 g/dL

    Author of lecture Approach to Shock

     Carlo Raj, MD

    Carlo Raj, MD

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