Shock (as cause of acute, severe SOB)

For the dyspneic patient in extremis, suspect Shock if:

  • Low B/P, Rapid Pulse (usually), poor capillary refill
  • Clear Lungs [? bibasilar rales if cardiogenic shock]
Differentiate Type of Shock:
  • Hypovolemic:  Bleeding / Massive diarrhea; Rapid Pulse
  • Septic:  Fever; Rapid Pulse
  • Cardiogenic:
    • History of recent chest pain; Cardiovascular risks
    • No reason to suspect Hypovolemic or Septic shock
    • Bradycardia (3° heart block)
    • Maybe Tachycardia (Atrial Fib/Flutter; Ventricular Tachycardia)
Stabilizing Measures:
  • Call 911.  Give O2.
  • Hypovolemic / Septic:  FLUIDS  (Normal Saline wide-bore IV)
  • Cardiogenic:    NO FLUIDS

See posting Acute Dyspnea – 1.