Tissue hypoperfusion kills quietly: identify the pattern, control the source, and restore perfusion to a clear target.
Uncontrolled hemorrhage
Hunt occult bleeding: abdomen, pelvis, retroperitoneum, GI.
Septic shock
Infective source + fluid-refractory hypotension.
Cardiogenic shock
Large infarct or arrhythmia — fluids may harm.
Obstructive shock
Tamponade, tension pneumothorax, massive PE — immediate causal therapy.
Anaphylaxis
Immediate IM adrenaline — nothing substitutes for it.
Lactate is the resuscitation compass: a value that will not fall means an uncontrolled source.
In hemorrhage: stopping it outranks replacing it.
External bleeding control with direct pressure or tourniquet, keep the patient warm, rapid transport with pre-alert.
Bleeding or fluid-loss history, flat neck veins.
Fever/source, initially warm periphery.
Chest pain or arrhythmia, crackles, distended neck veins.
Allergen exposure, urticaria, edema, wheeze.
| Drug | Dose | Route | Notes |
|---|---|---|---|
| Adrenaline (anaphylaxis)⚠ Critical | 0.5 mg IM | IM — lateral thigh | Repeat after 5 min if needed |
| Noradrenaline⚠ Critical | Target-guided infusion | Central IV / temporary peripheral | First-line in septic shock |
Subject to clinical review and local protocol.
بنية العرض مقتبسة من Notfallguru.de بموافقة فريقه — المحتوى بانتظار مراجعتهم
This content is an educational reference and does not replace clinical judgement or local protocols.
