Li et al reported criteria for the diagnosis of shock in an adult presenting to the Emergency Department. The authors are from the Chinese University of Hong Kong, Guangzhou Medical University, the Hong Kong University of Science and Technology, Charles Sturt University, and Bathurst Base Hospital.
Parameters:
(1) skin signs of tissue perfusion
(2) blood pressures (systolic and mean arterial)
(3) laboratory findings of acid-base status
(3a) blood lactate in mmol/L
(3b) arterial pH
(3c) base deficit in mmol/L
Laboratory Value
Finding
Diagnosis
blood lactate
< 1.5
normal
1.5 to 3.9
possible shock
>= 4.0
shock
arterial pH
> 7.3
normal
7.1 to 7.3
possible shock
< 7.1
shock
base deficit
> -3
normal
-3 to -5
possible shock
< -5
shock
Diagnosis of Shock
Skin Signs
Blood Pressures
Lab Findings
Diagnosis
skin mottling
SBP < 90 and MAP < 65
any of the shock findings
shock
no skin mottling
SBP >= 90 and MAP >= 65
all normal
normal
A patient who does not meet either shock or normal is classified as possible shock.
If shock is present then the skin temperature is classified as cold, warm or hot.
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