Shock is cellular oxygen failure, and the blood pressure is the last number to admit it. Enter a set of observations and the lab computes the mean arterial pressure, the pulse pressure and the urine output per kilogram, then stages the patient and names the finding that gave it away. Then switch to the fingerprint bench and watch preload, cardiac output, resistance and venous saturation move as you change the shock type.
Enter what you actually collected at the bedside. The lab does the arithmetic you are expected to do in your head — MAP = (systolic + 2 × diastolic) ÷ 3, target at least 65 mmHg; pulse pressure = systolic − diastolic; and urine output in mL/kg/hr, where the floor is 0.5.
Preset patients
Vital signs
Assessment
Change any field and the staging updates live.
Three of the four categories look identical at the bedside — cold, clamped down, tachycardic — because the body compensates for low flow the same way whatever the cause. Distributive shock is the odd one out. Pick a category and read the four numbers that separate it.
Choose the shock state
The three questions that sort every shock
Is there enough in the tank? Preload, estimated by CVP 2 to 8 mmHg or pulmonary artery wedge pressure 6 to 12 mmHg.
Is the pump working? Cardiac output 4 to 8 L/min, cardiac index 2.5 to 4.0 L/min/m².
Are the pipes constricted appropriately? Systemic vascular resistance 800 to 1200 dynes·s·cm⁻⁵.
Then read the SvO₂ (60 to 80 percent, or central venous around 70 percent) to see whether the tissues are extracting the oxygen you deliver.