Monday, January 25, 2021

Subtle Presentations of Shock

emDocs - January 25, 2021 - By Michael Andrew Tandlich and Katharine Colton
Reviewed by: Anthony DeVivo; Alex Koyfman; Brit Long
"Pearls & Pitfalls:
  • Avoid anchoring on a single diagnosis, especially among a demographic at higher risk of presenting with atypical and vague symptoms such as the young and the elderly.
  • Maintain a broad differential diagnosis when approaching an elderly patient in discomfort or distress, even in the absence of vital sign instability.
  • Shock index is a useful noninvasive bedside assessment of circulatory status defined by the ratio of heart rate to systolic blood pressure whose elevation may help identify shock early on.
  • Suspect tension pneumothorax in any patient breathing unassisted with respiratory distress, even in the absence of hypotension and tracheal deviation.
  • Consider anaphylaxis even in the absence of mucocutaneous symptoms, which may be absent in up to 20 percent of anaphylaxis cases."