Undifferentiated shock - Revision history

Danbot: Add evidence-based Disposition section

2026-03-22T10:03:05Z

Add evidence-based Disposition section

← Revisión anterior		Revisión del 10:03 22 mar 2026
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	**Dx: Clinical, consider [[RUSH exam]]		**Dx: Clinical, consider [[RUSH exam]]
	**Tx: Address underlying cause		**Tx: Address underlying cause

			==Disposition==
			*All patients with shock require ICU admission
			*Early identification and treatment of reversible causes is critical
			*Reassess frequently for response to interventions
			*Consider transfer to higher level of care if cause cannot be identified or adequately treated

	==See Also==		==See Also==

Danbot: Add MAP_Calculator to page

2026-03-21T16:31:38Z

Add MAP_Calculator to page

← Revisión anterior		Revisión del 16:31 21 mar 2026
Línea 86:		Línea 86:
	== Calculators ==		== Calculators ==
	{{Shock_Index_Calculator}}		{{Shock_Index_Calculator}}

			{{MAP_Calculator}}

	==External Links==		==External Links==

Danbot: Move calculators to own section with header (visible in TOC), expanded, before External Links

2026-03-21T15:05:45Z

Move calculators to own section with header (visible in TOC), expanded, before External Links

← Revisión anterior		Revisión del 15:05 21 mar 2026
Línea 83:		Línea 83:
	*[[Ultrasound in Shock and Hypotension]]		*[[Ultrasound in Shock and Hypotension]]
	*[[Pediatric shock]]		*[[Pediatric shock]]

			== Calculators ==
			{{Shock_Index_Calculator}}

	==External Links==		==External Links==
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	{{#widget:YouTube\|id=rOADTgtWuD4}}		{{#widget:YouTube\|id=rOADTgtWuD4}}
	{{#widget:YouTube\|id=uZgusFEwmmk}}		{{#widget:YouTube\|id=uZgusFEwmmk}}


	~~<div class="mw-collapsible mw-collapsed" style="border:1px solid #aaa; padding:5px; margin-top:10px;">~~
	~~<div style="font-weight:bold;">📊 Shock Index Calculator [show]</div>~~
	~~<div class="mw-collapsible-content">~~
	~~{{Shock_Index_Calculator}}~~
	~~</div>~~
	~~</div>~~
	[[Category:Critical Care]]		[[Category:Critical Care]]
	[[Category:Cardiology]]		[[Category:Cardiology]]

Danbot: Add Shock Index calculator (collapsible)

2026-03-21T13:50:14Z

Add Shock Index calculator (collapsible)

← Revisión anterior		Revisión del 13:50 21 mar 2026
Línea 94:		Línea 94:
	{{#widget:YouTube\|id=uZgusFEwmmk}}		{{#widget:YouTube\|id=uZgusFEwmmk}}


			<div class="mw-collapsible mw-collapsed" style="border:1px solid #aaa; padding:5px; margin-top:10px;">
			<div style="font-weight:bold;">📊 Shock Index Calculator [show]</div>
			<div class="mw-collapsible-content">
			{{Shock_Index_Calculator}}
			</div>
			</div>
	[[Category:Critical Care]]		[[Category:Critical Care]]
	[[Category:Cardiology]]		[[Category:Cardiology]]

Ostermayer at 00:43, 16 January 2026

2026-01-16T00:43:00Z

← Revisión anterior		Revisión del 00:43 16 ene 2026
Línea 1:		Línea 1:
	{{~~Adult top~~}} ~~[[undifferentiated shock]].''~~		{{AdultPage\|undifferentiated shock}}
	==Overview==		==Overview==
	*Inadequate perfusion of the tissues		*Inadequate perfusion of the tissues

Elcatracho: /* Causes of non-response to vasopressorsAnand Swaminathan, "Occult Causes of Non-Response to Vasopressors", REBEL EM blog, July 13, 2017. Available at: https://rebelem.com/occult-causes-of-non-response-to-vasopressors/. */

2021-03-09T21:02:03Z

Causes of non-response to vasopressorsAnand Swaminathan, "Occult Causes of Non-Response to Vasopressors", REBEL EM blog, July 13, 2017. Available at: https://rebelem.com/occult-causes-of-non-response-to-vasopressors/.

← Revisión anterior		Revisión del 21:02 9 mar 2021
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	**Tx: Transfusion, treat coagulopathy, surgery/IR interventions		**Tx: Transfusion, treat coagulopathy, surgery/IR interventions
	*[[Toxicology (main)\|Toxicologic]]		*[[Toxicology (main)\|Toxicologic]]
	**Dx: Clinical (consider [[beta blocker toxicity]], [[calcium channel blocker toxicity]], [[TCA overdose]], etc		**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)		**Tx: Depends on etiology (glucagon, hyperinsulin euglycemia therapy, sodium bicarbonate, ECMO, etc)
	*2nd cause of shock		*2nd cause of shock

Elcatracho: /* Management */

2021-03-09T21:01:25Z

Management

← Revisión anterior		Revisión del 21:01 9 mar 2021
Línea 53:		Línea 53:

	{{Vasopressor table}}		{{Vasopressor table}}

			===Causes of non-response to vasopressors<ref>Anand Swaminathan, "Occult Causes of Non-Response to Vasopressors", REBEL EM blog, July 13, 2017. Available at: https://rebelem.com/occult-causes-of-non-response-to-vasopressors/.</ref>===
			*[[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]]
			*[[Hemorrhagic shock\|Occult bleeding]]
			**Dx: Clinical (consider [[GI bleed]] and retroperitoneal hematoma)
			**Tx: Transfusion, treat coagulopathy, surgery/IR interventions
			*[[Toxicology (main)\|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

	==See Also==		==See Also==

Rossdonaldson1 at 22:41, 1 July 2020

2020-07-01T22:41:20Z

← Revisión anterior		Revisión del 22:41 1 jul 2020
Línea 1:		Línea 1:
	{{Adult top}} [[~~pediatric~~ shock]]		{{Adult top}} [[undifferentiated shock]].''
	==Overview==		==Overview==
	*Inadequate perfusion of the tissues		*Inadequate perfusion of the tissues

Rossdonaldson1 at 23:53, 28 November 2019

2019-11-28T23:53:07Z

← Revisión anterior		Revisión del 23:53 28 nov 2019
Línea 1:		Línea 1:
			{{Adult top}} [[pediatric shock]]
	==Overview==		==Overview==

	*Inadequate perfusion of the tissues		*Inadequate perfusion of the tissues
	*Goal to increase the flow of oxygenated blood to the tissues		*Goal to increase the flow of oxygenated blood to the tissues

ClaireLewis at 18:47, 26 September 2019

2019-09-26T18:47:42Z

← Revisión anterior		Revisión del 18:47 26 sep 2019
Línea 11:		Línea 11:

	*Pulse (assess based on patient's age)		*Pulse (assess based on patient's age)
	**Too slow or too fast (to the point where CO is affected)?		**Too [[bradycardia\|slow]] or too [[tachycardia\|fast]] (to the point where CO is affected)?
	***If so, HR is likely primary etiology of hypotension		***If so, HR is likely primary etiology of hypotension
	***Pace or cardiovert		***Pace or cardiovert
	*Volume ~~Status~~		*Volume status
	**What is the LV end-diastolic volume?		**What is the LV end-diastolic volume?
	***Approximated by the [[IVC ultrasound\|IVC diameter]] or CVP		***Approximated by the [[IVC ultrasound\|IVC diameter]] or CVP
	***If low:		***If low:
	****Assess for blood loss versus fluid loss		****Assess for [[hemorrhage\|blood]] loss versus [[hypovolemia\|fluid loss]]
	*****[[FAST exam\|FAST]] for intra-abdominal bleed		*****[[FAST exam\|FAST]] for intra-abdominal bleed
	*****US for ruptured [[Aortic ultrasound\|AAA]]		*****US for ruptured [[Aortic ultrasound\|AAA]]
	*****Guaiac for GI bleed		*****Guaiac for [[GI bleed]]
	*****[[CXR]] for hemothorax		*****[[CXR]] for [[hemothorax]]
	****Treat with IVF and/or ~~pRBC~~ depending on cause		****Treat with [[IVF]] and/or [[pRBCs]] depending on cause
	*Contractility		*Contractility
	**Is the myocardium severely depressed in its contractile function (cardiogenic shock)?		**Is the myocardium severely depressed in its contractile function ([[cardiogenic shock]])?
	***Assess via [[Ultrasound: In Shock and Hypotension\|ultrasound]]		***Assess via [[Ultrasound: In Shock and Hypotension\|ultrasound]]
	***Treat with inotrope		***Treat with inotrope (e.g. [[epinephrine]], [[dopamine]]
	**Is forward flow occurring?		**Is forward flow occurring?
	***Assess for valvular dysfunction (MR, AR)		***Assess for valvular dysfunction ([[mitral regurgitation\|MR]], [[aortic regurgitation\|AR]])
	***Assess for obstruction (PE, tamponade)		***Assess for obstruction ([[PE]], [[tamponade]])
	*Systemic Vascular Resistance		*Systemic Vascular Resistance
	**Pathologic vasodilation (decreased SVR) suggested by:		**Pathologic vasodilation (decreased SVR) suggested by:
Línea 45:		Línea 45:
	===Consider RUSH to CVS===		===Consider RUSH to CVS===
	*[[RUSH exam]]		*[[RUSH exam]]
	*Calcium bolus as inotrope		*[[calcium chloride\|Calcium]] bolus as inotrope
	*[[Vasopressin]]		*[[Vasopressin]]
	*Steroids, stress-dose, mineralocorticoids		*[[Steroids]], stress-dose, mineralocorticoids

	==Management==		==Management==