Bruce Way talks to Dr Rob Hislop about an approach to the management of undifferentiated shock in Part 2 of this two-part series. Listen to Part 1: Undifferentiated shock here.
Summary writer: Nathan Trist
Editor: James Edwards
Interviewee: Rob Hislop
Robert Hislop is a senior intensivist at Royal Prince Alfred Hospital and the director of the ICU at the Mater Hospital (North Sydney). He is a Clinical Lecturer at the University of Sydney with a strong interest in medical education. He is also an active volunteer with Open Heart International.
With Dr Rob Hislop Intensive Care Unit consultant, Royal Prince Alfred Hospital and Dr Bruce Way, Emergency Physician and Director of Prevocational Education and Training at Prince of Wales Hospital
Shock is a state where there is inadequate perfusion of tissues. Causes can be broadly categorised into vasodilatory, cardiogenic, hypovolaemic and obstructive shock. These categories and an approach to undifferentiated shock will be explored here.
A 78-year-old man on the cardiac ward has been admitted for either pneumonia or heart failure, the diagnosis is unclear. He is now febrile, BP 99/68, HR 80, SaO2 93 on 2L, RR 24.
He has not breached any parameters and the nurses ask for review because he is due for his evening metoprolol and his BP has steadily been decreasing.
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