Amal Mattu goes through the most classic and common pitfalls when treating shock, from Essentials of Emergency Medicine 2018. Grab more great high-yield lectures and watch anytime, anywhere with Essentials On-Demand: bit.ly/2A4qQjG
Excellent lecture as always! DDX Shock= Septic, spinal,, deHydration/hemorrhage,, Obstructive tamponade, tension Pneumthx, Compartment synd, cardiogenic,, K=endoKrine, anaphylaKtic. Hypotenisve pt--May add pressors (Norepi) if fluids not enough by 30 min. ( mortatlity/infarction increases 5% /hr if hypoTensive). be more liberal with cardioversion/shock. If pressure drops with fluid, think PE. Raising legs is like giving a bolus of 250--to see if fluids need to be given. Calculate shock index,, hr/sbp0.8. DO NOT intubate.
This gentleman/doctor is SPOT ON when he talks about hypotension and tissue infarction. Every minute a patient is hypotensive tissue is dying and much of this organ injury is completely irreversible. Even if a patient is non-toxic appearing do not let them sit with suboptimal perfusion. Great lecture. His K was a bit of a stretch though haha!
Sir...... if only I had seen this in the early days of my medic career!! Those HypoK+ strips... I had so many of those in the field. Was taught "prolonged QT with inversion". Even a couple ED docs didn't recognize it. Shaking my head! And fascinating info on the Shock Index!! I love this field! I love how there is always more to learn! 23 years in and STILL learning!! Thank you for doing the vids, sir!
We live 2 parts of our lives in diastole! Genius! I used to have a problem explaining that to surgeons that I have worked with, during the part of my career working in Cardiac Surgery ICU. They just love SBP below 120 mmHg no matter what the MAP value is.
Great little lecture. Great delivery. A little comment here tho; please do NOT wait for an X-ray to pick up tension ptx as mentioned here <a href="#" class="seekto" data-time="140">2:20</a>
Great sir. Thank you. Lots of new learning. Shock index, DBP importance, Pressors right away in PE- all life altering . Both for physicians and PATIENTS
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What happens when you give 1L of fluids in patients with low hb (5g/dl) and low bp 90/35mmHg? Are we treating the shock or worsening with hemodilution?
Triangle of death - hemodilution ,acidosis and hypothetmia is killer so if u have low hb in go warm blood and blood products ,giving fluids is a bad idea