UMEM Educational Pearls

Category: Critical Care

Title: Shock Index

Posted: 12/8/2009 by Mike Winters, MBA, MD (Updated: 6/15/2024)
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Early Recognition of Shock

  • Early recognition, and thus early treatment, of shock is crucial in reducing morbidity and mortality in the critically ill ED patient.
  • Traditionally, the diagnosis of shock has been based on vital sign abnormalities such as tachycardia, tachypnea, oliguria, etc.
  • Vital sign abnormalities have been shown to be insensitive markers of shock in the critically ill.
  • The Shock Index, although clearly not 100% sensitive, can assist in the detection of shock compared to heart rate and blood pressure alone.
  • Shock Index is simply heart rate divided by systolic blood pressure.
  • Values greater than 0.9 are abnormal and suggest markedly impaired cardiac output.

References

Strehlow MC. Early identification of shock in critically ill patients. Emerg Med Clin N Am 2010:28:57-66.