The Pressor is On
These are the main adrenergic receptors for vasopressor activity
alpha-1, beta-1, and beta-2, dopamine
Your patient in septic shock requires intubation, and this RSI med should be avoided
Etomidate (adrenocortical supression)
A patient with a critical coarct experiences this type of shock
Obstructive
These are the three stages of shock
Compensated, hypotensive, irreversible
Which of the following patients is not considered hypotensive?
a. 8 year old with SBP 85
b. 12 month old with SBP 75
c. 22 day old with SBP 50
d. 3 month old with SBP 60
b.
- 0 to 28 days: <60 mmHg
- 1 month to 12 months: <70 mmHg
- 1 to 10 years old: <(70 mmHg + [2 x age in years])
- ≥10 years old: <90 mmHg
This pressor can increased blood flow to the kidneys
Dopamine
Neurogenic shock can occur with injuries above this spinal level
T6
This is the box warning side effect associated with the drug used to treat critical coarct
4 x 25x 10 = 1000 mL over 24 hours + maintenance
The term used to describe decreased responsiveness to successive doses of a drug
Tachyphylaxis
This is the class of drugs that milrinone belongs to
PDE inhibitors
Your patient has a tension pneumothorax. These are the two anatomical needle thoracostomy locations
fifth ICS in the midaxillary line (ATLS), or second ICS in the midclavicular line
These are the three anatomical approaches to an emergency pericardiocentesis
Subxiphoid (subcostal), parasternal, apical
In burn patients, fluid resuscitation is maintained to target this rate of urine output in children
1.0 mL/kg/h
Septic, anaphylactic, neurogenic
This is the difference between effects of low dose and high dose epinephrine infusions
CO ↑↑, SVR ↓ (low dose) SVR/↑ (higher dose)
Which of the following is not a symptom of spinal shock?
a. bladder incontinence
b. areflexia
c. cool hands and feet
d. priapism
c. cool hands and feet
Usually cool below the level, flushed above the level (autonomic dysreflexia)
While doing a pericardiocentesis in an adolescent, removal of 5-10 mL of fluid can increase the stroke volume by up to this %
25-50%
A toddler presents with hypotension and bradycardia after ingesting grandma's pills. This is the likely drug ingested
CCB and BB's
This is the leading cause of pediatric shock worldwide
Hypovolemia from gastroenteritis
Name two known complications of vasopressors
Extravasation, hypoperfusion, dysrhythmia, MI, hypoglycemia
This is the percentage of blood loss associated with changes in mental status and urine output
Class 3 hemorrhagic shock - 30-40% blood loss
During your trauma rotation, a patient is in shock from massive blood loss. Name 3 contraindications for performing and ED thoracotomy
- Patient has no pulse or blood pressure in the field
- Asystole is the presenting rhythm and there is no pericardial tamponade
- Prolonged pulselessness (over 15 minutes) during resuscitation
- Massive, nonsurvivable injuries have occurred
- No thoracic or trauma surgeon is available within approximately 45 minutes
A toddler was found with shallow breathing, bradycardia and hypotension after clonidine ingestion. You try giving this medication, which has been used with inconsistent results
Naloxone
12yF with chronic steroid use presents with altered mental status, fever and hypotension. In addition to fluids and antibiotics, this is the other medication AND dose you would give
100 mg (age based) or 1 to 2 mg/kg (weight based) IV hydrocortisone
- BSA-based hydrocortisone dose:
Initial IV dose 50 to 100 mg/m2 (preferred if the BSA can be promptly calculated)
- Weight-based hydrocortisone dose: Initial IV dose 1 to 2 mg/kg (maximum single dose 100 mg)
- Age-based hydrocortisone dose:
• <3 years old: Initial IV dose 25 mg
• 3 to 12 years old: Initial IV dose 50 mg
• 12 years and older: Initial IV dose 100 mg