ICU Vivas · Resuscitation
Clinical viva — your approach to the patient in shock
A clinical viva on the structured approach to shock — the recognition and the four types, the restoration of delivery (fluid to the responsive, blood, oxygen, vasopressor/inotrope), the perfusion endpoints, and the avoidance of over-resuscitation.
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Target exams
CICMFFICMEDIC
Prompt
A clinical viva on the structured approach to shock — the recognition and the four types, the restoration of delivery (fluid to the responsive, blood, oxygen, vasopressor/inotrope), the perfusion endpoints, and the avoidance of over-resuscitation.
The question
"Take me through your approach to a patient who presents in shock."[1]
References4ShowHide
- [1]Rivers E, Nguyen B, Havstad S, et al. Early goal-directed therapy in the treatment of severe sepsis and septic shock. New England Journal of Medicine, 2001.PMID 11794169
- [2]Yealy DM, Kellum JA, Huang DT, et al. A randomized trial of protocol-based care for early septic shock (ProCESS). New England Journal of Medicine, 2014.PMID 24635773
- [3]Hernández G, Ospina-Tascón GA, Damiani LP, et al. Effect of a Resuscitation Strategy Targeting Peripheral Perfusion Status vs Serum Lactate Levels on 28-Day Mortality Among Patients With Septic Shock (ANDROMEDA-SHOCK). JAMA, 2019.PMID 30772908
- [4]Bersten AD, Soni N (eds) Oh's Intensive Care Manual. 8th edition, Elsevier, 2018.