Great question! For non-tachycardic shock, I usually first think about neurogenic shock but also think about a toxic OD (BB like you said, also CCBs), HyperK can do it too, but hyperK can do whatever it wants. Interestingly you can get a paradoxical bradycardia with hemorrhagic shock, but it isn’t common (https://pmc.ncbi.nlm.nih.gov/articles/PMC6541057/)
That's a great summary of non-tachycardic shock right there! I didn't know about paradoxical bradycardia, and yet this seems so important to be aware of, especially given that it's argued to be a sign of more significant bleeding, as suggested in the article you shared. Thanks again!
Great post, I recently had a patient with t9 fracture and initially presented with hypotension, resolved with Norepi, but never had goal map or 80 or higher, we maintained the normal MAP >65. stayed in icu for 2 days prior to transfer to tertiary care at neurosurgery center. Will keep in mind for future patient care amd advocate for my patients...thank you.
Great case, thank you! Shock with a HR of only 67, unique to neurogenic shock, right? Unless the patient was on a high dose of a beta blocker.
Great question! For non-tachycardic shock, I usually first think about neurogenic shock but also think about a toxic OD (BB like you said, also CCBs), HyperK can do it too, but hyperK can do whatever it wants. Interestingly you can get a paradoxical bradycardia with hemorrhagic shock, but it isn’t common (https://pmc.ncbi.nlm.nih.gov/articles/PMC6541057/)
That's a great summary of non-tachycardic shock right there! I didn't know about paradoxical bradycardia, and yet this seems so important to be aware of, especially given that it's argued to be a sign of more significant bleeding, as suggested in the article you shared. Thanks again!
Great post, I recently had a patient with t9 fracture and initially presented with hypotension, resolved with Norepi, but never had goal map or 80 or higher, we maintained the normal MAP >65. stayed in icu for 2 days prior to transfer to tertiary care at neurosurgery center. Will keep in mind for future patient care amd advocate for my patients...thank you.
Thanks!! I'm glad you enjoyed it!
My idiocy... I wondered about LBBB?
Not a silly question at all. I think the PVC beat (8th complex) is throwing you for a loop. The native rhythm isn't wide enought to be an LBBB
I love the way you do these!!
Thanks!