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Introduction
  • Inadequate tissue perfusion as consequence of cardiac failure.

Read the complete article; Shock in the Medical Library >  Pathophysiology.

Clinical Presentation
  • Decreased mental status
  • Pulmonary oedema
  • Dysrhythmias
  • Symptomatic hypotension
  • Wheeze
Exclusion Criteria
Exclusion Criteria
Risk Assessment
  • Do not administer IV saline with pulmonary oedema unless the patient is symptomatic from hypotension. In this scenario careful titration of fluid is needed.
  • Do not try to suction any more than necessary to maintain clear airway as fluid will be continuously flowing
  • Beware of sudden cardiac arrest
Management
Primary Care
  • Primary Survey
  • Ensure patient is positioned sitting or semi-recumbent (BP permitting)
  • Consider suction; (note: Do not suction pulmonary oedema fluid away any more than is essential to clear airway, as it will keep producing).
  • Consider Oxygen
  • Vital Sign Survey
  • Consider Secondary/CNS Survey to identify other causes of shock
Intermediate Care (EMT / Level 2)
  • Apply cardiac monitor if trained and authorised.
  • If IV in situ, maintenance fluid TKVO only.
  • Monitor patient persistently, recording full observations every 10 minutes (or 5 minutes if time critical)
  • Transport Priority 1 if patient time critical, pre-notifying receiving facility
Advanced Care (AP)
Critical & Extended Care (CCP, PSO)
  • As per Advanced Care (AP) guidelines
Additional Information
  • Clinical deterioration
  • Hemodynamic instability
  • Dysrhythmias
  • Cardiac Arrest

References
References
Key Terms & Links
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