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Early Recognition of Shock
- Early recognition, and thus early treatment, of shock is crucial in reducing morbidity and mortality in the critically ill ED patient.
- Traditionally, the diagnosis of shock has been based on vital sign abnormalities such as tachycardia, tachypnea, oliguria, etc.
- Vital sign abnormalities have been shown to be insensitive markers of shock in the critically ill.
- The Shock Index, although clearly not 100% sensitive, can assist in the detection of shock compared to heart rate and blood pressure alone.
- Shock Index is simply heart rate divided by systolic blood pressure.
- Values greater than 0.9 are abnormal and suggest markedly impaired cardiac output.
References
Strehlow MC. Early identification of shock in critically ill patients. Emerg Med Clin N Am 2010:28:57-66.