Circulation (Shock)
EM Clerkship
Zack Olson, MD ; Mike Estephan, MD ; Maddie Watts, MD
4.9 • 816 Ratings
🗓️ 26 April 2016
⏱️ 9 minutes
🧾️ Download transcript
Summary
Tank. Clogged Pipes. Broken Pipes. Pump.
Introduction
* “Tank”* Hypovolemic shock* Hemorrhagic shock* “Clogged Pipes”* Cardiac tamponade* Tension pneumothorax* Pulmonary embolism* “Broken Pipes”* Septic Shock* Neurogenic Shock* Anaphylactic Shock* “Pump”* Cardiogenic Shock
Step 1: Fill the Tank
* Establish an IV* IO line alternative in emergent situations
Step 2: Consider Clogs
* Cardiac tamponade* Diagnosis: Ultrasound* Treatment: Pericardiocentesis* Tension pneumothorax* Diagnosis: Clinical/Xray/Ultrasound* Treatment: Needle decompression and tube thoracostomy* Pulmonary embolism* Diagnosis: Clinical/CTA* Treatment: Thrombolytics
Step 3: Squeeze the Pipes
* Administer vasopressors* Most common: Norepinephrine* Alternatives: Epinephrine, Phenylepherine
Step 4: Analyze the Pump
* Get an EKG* Ischemia = Aspirin/Heparin/Cath lab* Dysrhythmia = Electricity
Additional Reading
* Airway Part 1 – Immediate Actions (EM Clerkship)* Breathing (EM Clerkship)* RUSH Exam (EMCrit)
Transcript
Click on a timestamp to play from that location
| 0:00.0 | Hello, med students. This episode has been sponsored by Freed AI. Do you dread the thought of |
| 0:07.1 | endless charting once you become a doctor? Do you think that doctors should be spending more |
| 0:11.9 | time with our patients and less time mindlessly writing notes? Freed AI is the product for you. It is a |
| 0:20.4 | secure, hippocompliant scribe that anybody can use. |
| 0:24.7 | Focus your energy on what matters, providing good patient care. |
| 0:29.5 | Use coupon code EM50 to save 50% the first month you try it, |
| 0:34.1 | and you can cancel at any time if you decide it's not right for you. You can learn more |
| 0:38.9 | at www.gitfreed.a.i. |
| 0:45.6 | Hello, med students. My name is Zach Olson, and today is episode C, circulation. It is sadly the third and final episode in our series about the |
| 0:58.0 | approach to a crashing patient. Now from the beginning, my goal has been to teach you a calm, |
| 1:05.3 | immediate, and methodical, A, B, C, approach, so that you can control literally any situation and really impress your |
| 1:16.2 | attendings when you're on your shifts. |
| 1:18.5 | So far, we talked about airway, how intubation doesn't actually have to be the first step |
| 1:23.2 | and how what you should really be thinking is suction and move the tongue. |
| 1:28.5 | We talked about breathing, how you can fix hypoxia just by adding FIO2 and peep. |
| 1:35.7 | And now is the final episode. |
| 1:38.3 | Circulation in 60 seconds. |
| 1:41.4 | I want to give a special shout out to my attending, Dr. Silberman. |
| 1:45.0 | He actually taught me this, gave a lecture on this in conference, and inspired this whole |
| 1:49.1 | episode. |
| 1:50.0 | So I really appreciated it, Dr. Silberman. |
| 1:52.5 | I still have never actually heard a better summary of this topic. |
... |
Please login to see the full transcript.
Disclaimer: The podcast and artwork embedded on this page are from Zack Olson, MD ; Mike Estephan, MD ; Maddie Watts, MD, and are the property of its owner and not affiliated with or endorsed by Tapesearch.
Generated transcripts are the property of Zack Olson, MD ; Mike Estephan, MD ; Maddie Watts, MD and are distributed freely under the Fair Use doctrine. Transcripts generated by Tapesearch are not guaranteed to be accurate.
Copyright © Tapesearch 2026.

