Ver el código de «Undifferentiated shock»

==Undifferentiated Hypotension Algorithm<ref>Morchi R. Diagnosis Deconstructed: Solving Hypotension in 30 Seconds. Emergency Medicine News. 2015.</ref>==
Check/manage the following in order:

[[File:Hypotension.png|thumbnail|Algorithm for the Evaluation of Hypotension (By Dr. Ravi Morchi)]]

*Pulse (assess based on patient's age)
**Too slow or too fast (to the point where CO is affected)?
***If so, HR is likely primary etiology of hypotension
***Pace or cardiovert
*Volume Status
**What is the LV end-diastolic volume?
***Approximated by the [[IVC ultrasound|IVC diameter]] or CVP
***If low:
****Assess for blood loss versus fluid loss
*****[[FAST exam|FAST]] for intra-abdominal bleed
*****US for ruptured [[Aortic ultrasound|AAA]]
*****Guaiac for GI bleed
*****[[CXR]] for hemothorax
****Treat with IVF and/or pRBC depending on cause
*Contractility
**Is the myocardium severely depressed in its contractile function (cardiogenic shock)?
***Assess via [[Ultrasound: In Shock and Hypotension|ultrasound]]
***Treat with inotrope
**Is forward flow occurring?
***Assess for valvular dysfunction (MR, AR)
***Assess for obstruction (PE, tamponade) 
*Systemic Vascular Resistance
**Pathologic vasodilation (decreased SVR) suggested by:
***Warm extremities
***Bounding pulse
**Treated based on likely etiology of distributive shock (see below)

==Differential Diagnosis==
{{Shock DDX}}

==Evaluation==
{{Shock index}}

==Management==
*Treat underlying type

{{Vasopressor table}}

==See Also==
*[[Ultrasound in Shock and Hypotension]]

==External Links==
*[http://pemplaybook.org/podcast/approach-to-shock/ Pediatric Emergency Playbook Podcast: Approach to Shock]

==References==
<references/>

==Video==
{{#widget:YouTube|id=rOADTgtWuD4}}

[[Category:Critical Care]]
[[Category:Cardiology]]