nextgen learning to elevate your airway practice
Introduction
To address shock in the peri-intubation period, you need to know how to identify it, differentiate it, and then be able to intervene upon it appropriately. The inadequate supply of blood and oxygen to the body’s tissues and organs that define shock often requires securing the airway, but this is only one aspect of the larger picture. Without understanding the positive and negative impacts your airway interventions can have on your overall resuscitation efforts, you may find yourself and your patient in unintended difficulty. Use this space to review some of the key features of shock to help you identify them.
General Appearance
Work of Breathing
Blood Pressure
The Shock Index
The shock index provides a simple and rapid way to evaluate the cardiovascular status of a patient. It is often used in emergency and critical care settings. An elevated shock index may indicate a higher risk of mortality or a more severe state of shock.
EVIDENCE-BASED
Nearly 25% of patients who are hemodynamically stable prior to intubation get post-intubation hypotension (PIH) after rapid sequence intubation. The Shock Index (SI) is easy to calculate and shown to be a strong predictor PIH.
Heffner A, Swords D, Nussbaum M, Kline J, Jones A. Predictors of the complication of postintubation hypotension during emergency airway management. J Crit Care. 2012;27(6):587-593. [PubMed]
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https://www.mdcalc.com/calc/1316/shock-index
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References
- Incidence and factors associated with cardiac arrest complicating emergency airway management. DOI: 10.1016/j.resuscitation.2013.07.022 Alan C Heffner 1, Douglas S Swords, Marcy N Neale, Alan E Jones
- Predictors of the complication of postintubation hypotension during emergency airway management. J Crit Care. 2012;27(6):587-593. [PubMed] Heffner A, Swords D, Nussbaum M, Kline J, Jones A.
- ALIEM: Shock Index: A Predictor of Morbidity and Mortality? By: Salim Rezaie, MD
- We suggest you add ALIEM and Salim Rezaie to your learning network!
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