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Neurogenic Shock in Children

Pediatric EM Morsels

Physical exam findings of occult shock in children can be subtle. Fortunately, there are screening tools for occult shock. A (sorta) Quick Blurb about Spinal Shock If you, like me, have recently had to go back to review the difference between spinal and neurogenic shock , here is a quick refresher on the topic.

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ECG Blog #432 — "Should I Shock this Patient?"

Ken Grauer, MD

No shock was needed. But considering that patients have been shocked for tracings resembling the ECG shown in Figure-1 — it may be worthwhile to present another example. RED arrows in Figure-2 highlight the surprisingly regular occurrence of what appears to be vertical lines that suggest possible QRS complexes. Is there a pulse?

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Anaphylactic Shock

RebelEM

Anaphylactic Shock is an acute, life-threatening hypersensitivity disorder, with a generalized, rapidly evolving, multi-systemic allergic reaction (IgE-mediated disorder). Anand Swaminathan, MD and I wrote the anaphylactic shock chapter and with Scott’s permission are publishing it here as FOAM.

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The ECLS-SHOCK Trial: ECPR in Infarct-Related Cardiogenic Shock

RebelEM

Background: Cardiogenic shock develops in up to 10% of patients with acute myocardial infarction (AMI) and carries a 30 day mortality rate around 50%. Extracorporeal Life Support in Infarct-Related Cardiogenic Shock. Many centers have attempted ECLS to achieve hemodynamic stabilization in this group of patients. Control: 53.4%

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REBEL Core Cast 115.0 – Cardiogenic Shock

RebelEM

Norepinephrine is a great first line vasopressor in Cardiogenic shock. Dobutamine is useful for inotropic support in Cardiogenic shock. Norepinephrine is a great first line vasopressor in Cardiogenic shock. Dobutamine is useful for inotropic support in Cardiogenic shock. Use POCUS in ED. Read more

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DanGer Shock – Microaxial Flow Pump in Infarct-Related Cardiogenic Shock

The Bottom Line

Microaxial Flow Pump or Standard Care in Infarct-Related Cardiogenic Shock Møller JE et al. DOI: 10.1056/NEJMoa2312572 Clinical Question In adults presenting with STEMI and cardiogenic shock does the use of a microaxial flow pump (Impella CP) compared to standard care reduce death from any cause at day 180?

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Adjunctive Methylene Blue in Septic Shock?

RebelEM

septic shock). Limited, small studies on its use in septic shock do not make a clear argument for use. Early Adjunctive Methylene Blue in Patients with Septic Shock: A Randomized Controlled Trial. Background: Sepsis can induce numerous physiologic derangements. Paper: Ibarra-Estrada, M et al. Crit Care 2023. 95% CI 15.4

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