Initial Managements
- Always Ensure that ABC’s are Secured
- Consider Getting the Placing “Lined Up”
- Central Venous Catheter for Fluid/Pressor Administration
- Arterial Line for Continuous Blood Pressure Monitoring
- In General, Stop Any Antihypertensives or Diuretics
Management of Undifferentiated Shock (Uncertain Cause)
- Start with a Bolus of Crystalloid Fluid – 1 Liter Lactated Ringer
- Consider Smaller Boluses (500 cc) in CHF
- Postoperative Patient May Require Multiple Fluid Boluses if Under-Resuscitated in the OR
- Consider Starting Vasopressors if Fluid Boluses Do Not Stabilize
- Ongoing Management Should Be Directed Based on Further Work-Up
Management of Differentiated Shock
- Hemorrhagic Shock:
- SIRS & Sepsis
- Other Forms of Shock:
Vasopressor Pharmacology