Sponsored by the Council of Residency Directors in Emergency Medicine
Goals and Objectives
Goals
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Trainee will demonstrate competence in the initial evaluation and basic management of patients with shock
Objectives
Trainee will be able to:
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List the four categories of shock and common etiologies for each category
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Hypovolemic
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Blood loss
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Dehydration
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Cardiogenic
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Arrhythmia
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ACS
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Heart Failure
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Valvular Disease
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Distributive
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Sepsis
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Neurogenic
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Anaphylaxis
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Endocrine
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Obstructive
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Pulmonary Embolism
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Tension Pneumothorax
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Cardiac Tamponade
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Describe history and physical exam findings to support the diagnosis of each type of shock
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Describe basic management of patients in each category of shock
Additional Resources
Approach, General
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Approach to Shock (EMCrit 2020)
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Approach to Shock (CDEM 2019)
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Initial Assessment, General
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The RUSH Exam
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Markers of Fluid Tolerance/Responsiveness
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IVC US for Fluid Tolerance (EMCrit 2012)
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IVC Roundup (EMCrit 2013)
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Pulse Pressure Variation (ACEP Critical Care)
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Markers of Shock
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ScvO2 (LITFL 2013)
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Therapeutics, General
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Choosing the right vasopressor agent in hypotension (ALIEM 2013)
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Vasopressors in Hypotension (ALIEM 2013)
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Push Dose Pressors (EMCrit 2009) (pdf)
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Anaphylactic Shock
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Anaphylaxis Practice Update, Systematic Review (J Allergy Clin Immunol 2020)
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Anaphylaxis (Core EM 2016)
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Allergy and Anaphylaxis (EB Medicine 2015)
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Cardiogenic Shock
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Cardiogenic Shock (EMCrit 2009)
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Unstable Atrial Fibrillation (EM Docs 2020)
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Crashing Atrial Fibrillation (EMCrit 2010)
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Hemorrhagic Shock
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Hemorrhagic Shock Resuscitation (EMCrit 2010)
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GI Bleeds and Hemorrhagic Shock (Pulmcast)
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Neurogenic Shock
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Neurogenic Shock (EMCrit 2020)
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Neurogenic Shock (Open Ped Med J 2013)
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Obstructive Shock
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Pneumothorax, Tension
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General
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Pneumothorax (CDEM 2019)
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Spontaneous Pneumothorax (ANZ J Surg 2018)
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Ultrasound
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US for Pneumothorax (REBEL EM 2014)
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Decompression
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Needle Decompression (REBEL EM 2020)
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Needle Decompression for Tension Pneumothorax (EPMonthly 2014)
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Pulmonary Embolism
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General
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Suspected Acute Venous Thromboembolic Disease (ACEP Clinical Policy 2018) (pdf)
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Acute Venous Thromboembolic Disease (ACEP Clinical Policy 2018) (pdf)
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PE Treatment Options (EMCrit 2014)
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Ultrasound​
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RV Strain (ACEP US)​
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Thrombolysis
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Thrombolysis for Submassive PE (LITFL 2016)
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Tamponade, Cardiac
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Acute Myopericardial Syndromes (EM:RAP 2021)
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Pericarditis and Tamponade (EM:RAP 2011)
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Acute Cardiac Tamponade (NEJM 2003)
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Ultrasound
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Pericadial Effusion vs. Tamponade (ALiEM 2019)​
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Pericardiocentesis
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Pericardiocentesis (HighlandEM US 2019)
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Pericardiocentesis (EM-in-5 2016)
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Septic Shock​
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See: Sepsis (EM Fundamentals)