ALGORITHM FOR DISTRIBUTIVE SHOCK
Distributive shock, commonly caused by sepsis or anaphylaxis, involves abnormal vasodilation and maldistribution of blood flow, leading to inadequate tissue perfusion.
Signs of Distributive Shock:
- Bounding pulses and warm extremities in early stages.
- Hypotension and poor perfusion in late stages.
- Altered mental status.
Management Algorithm:
- Step 1: Administer high-flow oxygen.
- Step 2: Establish vascular access and give 20 mL/kg fluid boluses.
- Step 3: Administer vasopressors (e.g., epinephrine for anaphylaxis, norepinephrine for septic shock) if perfusion does not improve with fluids.
- Step 4: Treat the underlying cause:
- Sepsis: Start broad-spectrum antibiotics.
- Anaphylaxis: Administer intramuscular epinephrine and adjunct therapies such as antihistamines and corticosteroids.
Timely interventions tailored to the underlying cause can rapidly stabilize distributive shock.
