A Narrative Review on Shock in the Emergency Room

Detalhes bibliográficos
Autor(a) principal: Dantas, Jorge
Data de Publicação: 2021
Outros Autores: Vaz, Rita, Morais, Rui, Verdasca, Irene
Tipo de documento: Artigo
Idioma: por
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/11704
Resumo: The patient in shock represents a common clinical challenge in the emergency room, and potentially represents an immediate lifethreatening situation that requires the intervention of different medical specialties in order for hemodynamic stabilization to be achieved. This paper reports a non-systematic review of the initial approach to the patient in shock, highlighting the adaptation of the instituted measures to the particularities of the emergency room environment. This review is structured according to a proposed protocol of action based on the early diagnosis of shock, the identification of the type of shock and the most likely cause, and the institution of supportive therapy. The initial stabilization of the patient should be guided by the identification of failing physiological mechanisms, having in mind that strategies with little meaning in other contexts may be of interest in the emergency room - as they are practical and can be rapidly implemented - as is the case with the administration of vasoactive drugs in bolus or by peripheral access.
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spelling A Narrative Review on Shock in the Emergency RoomRevisão Narrativa sobre Choque na Sala de EmergênciaEmergency ServiceHospitalShock/diagnosisShock/etiologyShock/therapyChoque/diagnósticoChoque/etiologiaChoque/tratamentoServiço de Urgência HospitalarThe patient in shock represents a common clinical challenge in the emergency room, and potentially represents an immediate lifethreatening situation that requires the intervention of different medical specialties in order for hemodynamic stabilization to be achieved. This paper reports a non-systematic review of the initial approach to the patient in shock, highlighting the adaptation of the instituted measures to the particularities of the emergency room environment. This review is structured according to a proposed protocol of action based on the early diagnosis of shock, the identification of the type of shock and the most likely cause, and the institution of supportive therapy. The initial stabilization of the patient should be guided by the identification of failing physiological mechanisms, having in mind that strategies with little meaning in other contexts may be of interest in the emergency room - as they are practical and can be rapidly implemented - as is the case with the administration of vasoactive drugs in bolus or by peripheral access.O doente em choque representa um desafio clínico comum na sala de emergência, e representa uma potencial situação de risco de vida imediato que requer a intervenção de diferentes especialidades médicas na sua estabilização. Neste trabalho realiza-se uma revisão não sistemática de recomendações internacionais e de literatura adicional sobre este tema, sob a perspectiva da abordagem ao doente na sala de emergência e das particularidades deste contexto. Esta revisão é estruturada segundo uma proposta de protocolo de actuação baseada no diagnóstico precoce do quadro de choque, na identificação do tipo de choque e da etiologia mais provável, bem como na instituição de terapêutica de suporte. É destacada a importância da estabilização inicial do doente ser orientada pela identificação dos mecanismos fisiológicos em falência, e identificadas estratégias que, fazendo pouco sentido noutros contextos, podem ter interesse na sala de emergência - dado serem práticas e de rápida implementação - como é o caso da administração defármacos vasoactivos por via periférica ou em bólus.Ordem dos Médicos2021-06-01info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfapplication/pdfapplication/pdfhttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/11704oai:ojs.www.actamedicaportuguesa.com:article/11704Acta Médica Portuguesa; Vol. 34 No. 6 (2021): June; 451-459Acta Médica Portuguesa; Vol. 34 N.º 6 (2021): Junho; 451-4591646-07580870-399Xreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPporhttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/11704https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/11704/6330https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/11704/11499https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/11704/11955Direitos de Autor (c) 2021 Acta Médica Portuguesainfo:eu-repo/semantics/openAccessDantas, JorgeVaz, RitaMorais, RuiVerdasca, Irene2022-12-20T11:06:22Zoai:ojs.www.actamedicaportuguesa.com:article/11704Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T16:20:04.665187Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv A Narrative Review on Shock in the Emergency Room
Revisão Narrativa sobre Choque na Sala de Emergência
title A Narrative Review on Shock in the Emergency Room
spellingShingle A Narrative Review on Shock in the Emergency Room
Dantas, Jorge
Emergency Service
Hospital
Shock/diagnosis
Shock/etiology
Shock/therapy
Choque/diagnóstico
Choque/etiologia
Choque/tratamento
Serviço de Urgência Hospitalar
title_short A Narrative Review on Shock in the Emergency Room
title_full A Narrative Review on Shock in the Emergency Room
title_fullStr A Narrative Review on Shock in the Emergency Room
title_full_unstemmed A Narrative Review on Shock in the Emergency Room
title_sort A Narrative Review on Shock in the Emergency Room
author Dantas, Jorge
author_facet Dantas, Jorge
Vaz, Rita
Morais, Rui
Verdasca, Irene
author_role author
author2 Vaz, Rita
Morais, Rui
Verdasca, Irene
author2_role author
author
author
dc.contributor.author.fl_str_mv Dantas, Jorge
Vaz, Rita
Morais, Rui
Verdasca, Irene
dc.subject.por.fl_str_mv Emergency Service
Hospital
Shock/diagnosis
Shock/etiology
Shock/therapy
Choque/diagnóstico
Choque/etiologia
Choque/tratamento
Serviço de Urgência Hospitalar
topic Emergency Service
Hospital
Shock/diagnosis
Shock/etiology
Shock/therapy
Choque/diagnóstico
Choque/etiologia
Choque/tratamento
Serviço de Urgência Hospitalar
description The patient in shock represents a common clinical challenge in the emergency room, and potentially represents an immediate lifethreatening situation that requires the intervention of different medical specialties in order for hemodynamic stabilization to be achieved. This paper reports a non-systematic review of the initial approach to the patient in shock, highlighting the adaptation of the instituted measures to the particularities of the emergency room environment. This review is structured according to a proposed protocol of action based on the early diagnosis of shock, the identification of the type of shock and the most likely cause, and the institution of supportive therapy. The initial stabilization of the patient should be guided by the identification of failing physiological mechanisms, having in mind that strategies with little meaning in other contexts may be of interest in the emergency room - as they are practical and can be rapidly implemented - as is the case with the administration of vasoactive drugs in bolus or by peripheral access.
publishDate 2021
dc.date.none.fl_str_mv 2021-06-01
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dc.type.driver.fl_str_mv info:eu-repo/semantics/article
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oai:ojs.www.actamedicaportuguesa.com:article/11704
url https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/11704
identifier_str_mv oai:ojs.www.actamedicaportuguesa.com:article/11704
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dc.relation.none.fl_str_mv https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/11704
https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/11704/6330
https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/11704/11499
https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/11704/11955
dc.rights.driver.fl_str_mv Direitos de Autor (c) 2021 Acta Médica Portuguesa
info:eu-repo/semantics/openAccess
rights_invalid_str_mv Direitos de Autor (c) 2021 Acta Médica Portuguesa
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
application/pdf
application/pdf
dc.publisher.none.fl_str_mv Ordem dos Médicos
publisher.none.fl_str_mv Ordem dos Médicos
dc.source.none.fl_str_mv Acta Médica Portuguesa; Vol. 34 No. 6 (2021): June; 451-459
Acta Médica Portuguesa; Vol. 34 N.º 6 (2021): Junho; 451-459
1646-0758
0870-399X
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