Refractory Cardiogenic Shock

Escalate to MCS

First 30 seconds

  1. 1ABCDE + arterial + central line
  2. 2Vasopressor (norad first-line)
  3. 3Inotrope (dobutamine 2.5–20 mcg/kg/min OR milrinone if on β-blocker)
A

Airway

  • Patency, protect
  • Adjuncts / definitive airway
B

Breathing

  • RR, SpO₂
  • O₂ to target sats
C

Circulation

  • HR, BP, IV access
  • Fluids/vasopressors
D

Disability

  • AVPU/GCS, pupils, glucose
E

Exposure

  • Full exposure, bleeding, source
View flowchart algorithm
WardRound

WardRound

Clinical Decisions in Seconds