Shock Differential

Question 1

Define pulse pressure:

Answer 1

PP = SBP - DBP

A PP less than half of the DBP is defined as “narrow.” A narrow PP is related to low stroke volume.

Another way of looking at it is:

PP = SV divided by Compliance

Question 2

Approximate percentages of types of shock presenting to ED

Answer 2

Distributive: 52%
Hypovolemic: 32%
Cardiogenic: 15%
Obstructive: 1%

Question 3

Examples of high stroke volume shock:

Answer 3

Sepsis
Anaphylaxis
Burns
Endocrine
Metabolic

Question 4

Examples of low stroke volume shock (low preload):

Answer 4

Hypovolemia
Hemorrhage
Ruptured AAA
Tension PTX
Tamponade

Question 5

Examples of low stroke volume shock (poor contractility):

Answer 5

LV dysfunction
RV dysfunction
BiV dysfunction

Question 6

Examples of low stroke volume shock (high afterload):

Answer 6

AS
Dissection
HTN