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In shock states, regardless of the type of shock, the main problem is inadequate organ perfusion. The most important pressure value related to organ perfusion is the MAP, which stands for Mean Arterial Pressure, not “main arterial pressure.” MAP can be estimated using this formula: MAP = DBP + 1/3(SBP − DBP) For example, a blood pressure of 90/60 mmHg gives a MAP of about 70 mmHg, which is usually acceptable as an initial perfusion target. In shock, the usual initial target is MAP ≥ 65 mmHg. However, we should not decide to start vasopressors based only on a blood pressure below 90/60 mmHg. The decision depends on whether the patient has hypotension with signs of organ hypoperfusion, such as altered mental status, low urine output, cold extremities, delayed capillary refill, metabolic acidosis, or elevated lactate. In general, vasopressors are started when hypotension or hypoperfusion persists despite appropriate initial resuscitation, especially after adequate fluid resuscitation if the patient is fluid responsive. In severe hypotension, vasopressors may be started early while resuscitation is ongoing. In septic shock, the first-line vasopressor is usually norepinephrine, and the initial target is MAP ≥ 65 mmHg. Weaning vasopressors could begin simply used because the blood pressure rises above 90/60 mmHg. ومعها ايضا We start reducing vasopressors when the patient has a stable MAP, usually ≥65 mmHg, along with improvement in organ perfusion, such as improving mental status, adequate urine output, decreasing lactate, better skin perfusion, and control of the underlying cause of shock.

البوردجية سوال شوكت ابلش Vasopressor وشوكت وشلون اوقف

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سؤال عملي للبوردجيةً A patient with dyslipidemia reached the guideline-recommended LDL-C target after treatment with a statin. Should the statin dose be reduced, discontinued, or continued?

دكتور هسة بعيداً عن التشخيص النهائي الي طلع مثلا واجهنة هيج مريض ،،، 1 asymptomatic 2 خلي نختصر ال finding كلهة ب Suspicious ecg هيج مريض مو لازم يندز troponin يلة وراها echo ؟

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همزين ما داخل الطوارئ لان جان وصل حتى CCU 🤣🤣

ارجعكم لنظام الحزورات الي تحبوه بدون هستري شنو نشوف بال ECG

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اَلسَّلامُ عَلَى الْحُسَيْنِ ، وَعَلَى عَلِيِّ بْنِ الْحُسَيْنِ وَعَلَى أَوْلادِ الْحُسَيْنِ وَعَلَى أَصْحَابِ الْحُسَيْنِ ورحمة اللَّهِ وبركاته