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Cardiology Corner - Cardiogenic Shock

Rob Orman, MD and Amal Mattu, MD FAAEM
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EMRAP 2016 January Summary 874 KB - PDF

We want to get patients with cardiogenic shock out of the ED and to the cath lab as soon as possible. That’s sometimes easier said than done.

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Amal M., M.D. -

Just to be clear about ECMO, it is still just a temporizing measure just like everything else, and is not a definitive therapy in post-MI cardiogenic shock. I hope that the key points that people got from the discussion were (1) there is no definitive therapy or protocol for these patients in the ED, (2) anyone who tells you that there IS a simple ED recipe for treatment that is well-researched and validated is fooling you...including the people that write ACLS, textbooks, board reviews, or plaintiff "experts", and (3) your goal is to do whatever you can do to keep these patients alive until they get upstairs to the cath lab or OR.
--AM

richard m., jr -

Excellent discussion. Thank you for that. Would anyone in the EMRAP world consider THAM for a rapid fix of the acidosis that can be seen in cardiogenic shock? I realize this isn't an FDA approved use of THAM. But...if the acidosis in cardiogenic shock is a contributing factor of the dysrythmias that can case cardiac arrest, especially during the time of RSI, could THAM theoretically be used as another temporizing measure to lessen this risk?

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Cracking The Chest Full episode audio for MD edition 254:13 min - 354 MB - M4AEMRAP 2016 January Aussie Edition Australian 27:57 min - 38 MB - MP3EMRAP 2016 January Canadian Edition Canadian 15:02 min - 21 MB - MP3EMRAP 2016 Janiver Résumé en Francais Français 63:14 min - 87 MB - MP3EMRAP 2016 Enero Resumen Español Español 83:06 min - 114 MB - MP3EMRAP 2016 January Board Review Answers 120 KB - PDFEMRAP 2016 January Board Review Questions 422 KB - PDFEMRAP 2016 January MP3 314 MB - ZIPEMRAP 2016 January Summary 874 KB - PDF

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