Treat underlying type
Acidosis
Dx: Blood gas, BMP
Tx: treat underlying cause, consider bicarbonate gtt
Hypothyroidism
Dx: Clinical, TSH
Tx: levothyroxine
Anaphylaxis
Dx: History
Tx: Epinephrine, methylene blue, ECMO
Adrenal insufficiency
Dx: Clinical, cortisol level, hyperkalemia + hyponatremia
Tx: Hydrocortisone 100-200mg
Hypocalcemia
Dx: ionized calcium, prolonged QTc
Tx: Calcium chloride or calcium gluconate
Occult bleeding
Dx: Clinical (consider GI bleed and retroperitoneal hematoma)
Tx: Transfusion, treat coagulopathy, surgery/IR interventions
Toxicologic
Dx: Clinical (consider beta blocker toxicity, calcium channel blocker toxicity, TCA overdose, etc)
Tx: Depends on etiology (glucagon, hyperinsulin euglycemia therapy, sodium bicarbonate, ECMO, etc)
2nd cause of shock
Dx: Clinical, consider RUSH exam
Tx: Address underlying cause
Dx: Blood gas, BMP
Tx: treat underlying cause, consider bicarbonate gtt
Dx: Clinical, TSH
Tx: levothyroxine
Dx: History
Tx: Epinephrine, methylene blue, ECMO
Dx: Clinical, cortisol level, hyperkalemia + hyponatremia
Tx: Hydrocortisone 100-200mg
Dx: ionized calcium, prolonged QTc
Tx: Calcium chloride or calcium gluconate
Dx: Clinical (consider GI bleed and retroperitoneal hematoma)
Tx: Transfusion, treat coagulopathy, surgery/IR interventions
Dx: Clinical (consider beta blocker toxicity, calcium channel blocker toxicity, TCA overdose, etc)
Tx: Depends on etiology (glucagon, hyperinsulin euglycemia therapy, sodium bicarbonate, ECMO, etc)
Dx: Clinical, consider RUSH exam
Tx: Address underlying cause
Undifferentiated shock
Cardiogenic
Neurogenic shock
Acute valvular Regurgitation/VSD
Spinal shock
CHF
Cardiogenic shock
Dysrhythmia