Shock Value
Sepsis
Just Venting
Bugs
ARDS
100

This type of shock presents with warm extremities early on, unlike the other shock types.

Distributive shock

100

This category of sepsis no longer exists, but it sure is stubbornly omnipresent.

Severe sepsis

100

These two ventilator settings impact oxygenation.

PEEP and FiO2

100

This bacteria should be considered for post-influenza PNA and skin/soft tissue infection patients.

What is MRSA?

100

These 4 criteria must be met to diagnose ARDS.

Berlin Criteria: 1 week since insult, bilateral lung opacities, Non-cardiogenic edema, low P/F ratio

200

A patient in shock has an elevated CVP, clear lungs, and distended neck veins — this largely rules out this common shock category.

Hypovolemic shock

200

This vasopressor has highest empirical support in treating septic shock.

Norepinephrine (aka Levophed/Levo)

200

This number represents the generated pressure gradient promoting air movement on BiPAP.

Delta Pressure (aka Driving Pressure)

200

Reach for this class of antibiotics when treating community-acquired pneumonia.

What are macrolides or fluoroquinolones?

200

This pressure represents alveolar pressure and is performed during an inspiratory hold.

Plateau pressure

300

This hemodynamic pattern — low cardiac output, high SVR, high filling pressures — should make you suspect this etiology of shock

Cardiogenic shock

300

This is a reasonable (though over-generalized) fluid bolus for a septic patient.

30cc/kg crystalloid

300

This ventilator mode can be used as a Spontaneous Breathing Trial, assessing readiness for extubation.

Pressure Support Ventilation

300

Anaerobes stand no chance against these antibiotics.

Metronidazole (Flagyl), piperacillin-tazobactam (Zosyn), carbapenems

300

This histologic hallmark of ARDS is marked by fluid filled, collapsed alveoli.

Diffuse Alveolar Damage

400

Muffled heart sounds, elevated JVD, and hypotension should clue you in to this type of shock due to this pathology.

Obstructive shock due to cardiac tamponade

400

A septic patient remains hypotensive despite adequate fluids and norepinephrine at a high dose; this adjunct is added next given a suspected relative deficiency.

Stress Dose Steroids / hydrocortisone

400

This mode of ventilation was abandoned due to patient-ventilator dysynchrony.

Intermittent mandatory ventilation

400

Despite empiric Vancomycin + Zosyn, an occult infection persists, thus leading you to add this other drug.

Anti-fungal (fluconazole, micafungin, caspofungin)

400

Other than ventilator management, therapy is one of the few ARDS interventions with clear mortality benefit.

Prone positioning

500

This medication has pure alpha-1 receptor agonism and risks reflexive bradycardia.

Phenylephrine

500

Derangements in these organ systems may earn a point on the sequential organ failure assessment scale.

Respiration, coagulation, liver, cardiovascular, CNS, renal

500

These are complications of mechanical ventilation related to the endotracheal tube itself.

Laryngeal injury, tracheal stenosis, tracheomalacia, tracheo-innominate artery fistula, tracheo-esophageal fistula

500

Despite broad antimicrobial coverage, occult infection persists, and thus these diagnostics may be warranted.

CT scan, echocardiogram, lumbar puncture, surgical wound re-exploration/washout

500

Only 20-30% of ARDS patient develop this unfortunate phase of disease, marked by honeycombing, decreased compliance, and pulmonary hypertension.

Fibrotic phase