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previews",[218,229,234,239,246],{"type":219,"data":220},"video",{"readDurationInSeconds":221,"video":222},129,{"platform":223,"name":224,"url":225,"size":226},"YouTube","Managing mixed shock states","https:\u002F\u002Fwww.youtube.com\u002Fwatch?v=fSKx5OS005s",{"width":227,"height":228},200,113,{"type":230,"data":231},"free_text",{"readDurationInSeconds":232,"text":233},10.133333333333333,"\u003Cp>Many problems can create a combination of more than one type of shock, and these situations require careful management. In this video from our Resuscitation Essentials course, you'll learn how to recognize and manage shock presenting as mixed-types, such as anaphylaxis, sepsis, and trauma.\u003C\u002Fp>",{"type":230,"data":235},{"readDurationInSeconds":236,"title":237,"text":238},10.666666666666666,"Join our Resuscitation Essentials course today!","\u003Cp>Learn how to evaluate and treat shock and to differentiate between types of shock (obstructive, cardiogenic, distributive, hypovolemic). With our \u003Cstrong>\u003Ca href=\"https:\u002F\u002Fwww.medmastery.com\u002Fcourse\u002Fresuscitation-essentials\">Resuscitation Essentials\u003C\u002Fa>\u003C\u002Fstrong> course, you'll master a step-by-step approach for managing patients near to, or experiencing, cardiac arrest in any environment. \u003C\u002Fp>",{"type":240,"data":241},"cta",{"readDurationInSeconds":242,"text":243,"buttonText":244,"buttonUrl":245},3.466666666666667,"Become a great clinician with our video courses and workshops","Start learning for free","https:\u002F\u002Fwww.medmastery.com\u002Fuser\u002Fregister",{"type":230,"data":247},{"readDurationInSeconds":248,"title":249,"text":250},54.666666666666664,"Video Transcript","\u003Cp dir=\"ltr\">\u003Cstrong>[00:00:00] \u003C\u002Fstrong>Many problems create a combination of more than one type of shock. For example, sepsis often causes a distributive shock but also creates hypovolemia through insensible losses and may result in aseptic cardiomyopathy decreasing cardiac function. Patients often require volume repletion in addition to antibiotic therapy and source control and may require vasoconstrictors to support their perfusion. Anaphylaxis, \u003C\u002Fp>\u003Cp dir=\"ltr\">\u003Cstrong>[00:00:30] \u003C\u002Fstrong>by definition, affects multiple organ systems. In addition to a vasodilatory shock, cardiogenic shock may occur. Bronchial constriction may lead to hypoxemia and decreased oxygen delivery to the heart and may also cause increased pulmonary vascular resistance and right-heart dysfunction; and gastrointestinal upset in capillary leaking may cause volume depletion. Elimination of the antigen when possible and epinephrine are the mainstays of treatment, which work on several of these pathways. Additional \u003C\u002Fp>\u003Cp dir=\"ltr\">\u003Cstrong>[00:01:00] \u003C\u002Fstrong>adjunctive therapies like antihistamines and steroids may help with symptoms and prevent relapse in some cases. Shock associated with trauma often has multiple components. Hemorrhage may lead to hypovolemic shock but the patient may also have concomitant injuries like a tension pneumothorax or hematoma, which can lead to obstructive shock. A neurologic injury may cause a neurogenic component as well. Interruption of the sympathetic ganglia may cause vasodilation and bradycardia with inability to compensate \u003C\u002Fp>\u003Cp dir=\"ltr\">\u003Cstrong>[00:01:30] \u003C\u002Fstrong>cardiac output. In addition to volume replacement, interventions to relieve obstruction or correct causes of bleeding may be necessary. Patients with neurologic injury may require vasopressors or chronotropes, usually after other causes have been addressed.\u003C\u002Fp>",{"courses":252,"showAwardsBelow":48},[253],{"id":254,"isFreeCmeCourse":255,"title":256,"type":257,"specialization":258,"teachers":260,"cmeCredits":262,"teacherIllustration":263,"backgroundImage":264,"relativeUrl":265,"lastChanged":266,"created":267,"description":268,"relativeURL":265,"meta":269},5236,false,"Resuscitation Essentials","course",[259],"Emergency medicine and critical care",[261],"Christopher R. Tainter, MD",3,"https:\u002F\u002Fmedmastery-backend-prod-kjbeds.s3.eu-west-1.amazonaws.com\u002Fmedia\u002Fimages\u002F99f55eb1-6358-434e-bd05-101915d2de76","https:\u002F\u002Fmedmastery-backend-prod-kjbeds.s3.eu-west-1.amazonaws.com\u002Fmedia\u002Fimages\u002F99f55eee-ca2a-4d37-beeb-eafdef1a9482","\u002Fcourses\u002Fresuscitation-essentials","1763556352","1533061301","Resuscitation is all about making rapid, life-saving decisions in the face of uncertainty. Algorithms give structure, but can’t cover every possible scenario. 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He is an internist with a specialization in cardiology and a master’s in public health from Johns Hopkins University.",{"name":303},"Internist",4,"\u002Fmagazine\u002Fexercise-stress-ecg-inoca",141,"3m",{"created":309,"updated":310,"published":311},1778115738,1778118425,1778118255,{"id":313,"title":314,"text":315,"image":316,"author":322,"path":324,"readDuration":325,"readDurationFormatted":326,"internal":327},1348,"Hyperlipidemia screening: who, when, & what to measure","Testing for hyperlipidemia can help you mitigate your patients' cardiovascular risk. Learn who to screen and when, which measures to request, and how to stratify risk.",{"alt":317,"title":290,"size":318,"location":320},"Lipid panel blood sample tubes used to test for hyperlipidemia in a laboratory setting",{"width":319,"height":319},600,{"bucket":294,"key":321},"\u002F2026-04\u002FC121_magazine image.png",{"id":297,"title":298,"relativeURL":299,"image":300,"professionLong":301,"profession":323,"weight":304},{"name":303},"\u002Fmagazine\u002Ftest-for-hyperlipidemia",246,"5m",{"created":328,"updated":329,"published":330},1777403036,1777572381,1777412421,{"id":332,"title":333,"text":334,"image":335,"author":340,"path":348,"readDuration":349,"readDurationFormatted":350,"internal":351},1347,"Outpatient care for COPD exacerbations","Most acute COPD exacerbations can be managed with outpatient treatment. Learn how to treat mild and moderate COPD exacerbations—and when to escalate care.",{"alt":336,"title":290,"size":337,"location":338},"Older patient using a handheld nebulizer to inhale bronchodilator medication during an acute COPD exacerbation",{"width":319,"height":319},{"bucket":294,"key":339},"\u002F2026-04\u002FC133(4)_ exacerbations_magazine image.png",{"id":341,"title":342,"relativeURL":343,"image":344,"professionLong":345,"profession":346,"weight":347},5365,"Siamak Moayedi, MD","\u002Fteachers\u002Fsiamak-moayedi-md","https:\u002F\u002Fmedmastery-backend-prod-kjbeds.s3.eu-west-1.amazonaws.com\u002Fmedia\u002Fimages\u002F9c43cf02-1064-4074-817b-0eb5de6ded74","Professor and Director of Medical Student Education, University of Maryland and Course Director, Essential and Critical Procedures, Emergency Medicine.",{"name":277},1533,"\u002Fmagazine\u002Facute-copd-exacerbation-treatment",191,"4m",{"created":352,"updated":353,"published":354},1776705362,1776710540,1776710541,{"seo":356,"og":358},{"title":357,"description":213},"Managing mixed-shock states | Medmastery",{"title":357,"description":213,"image":359},{"alt":290,"title":290,"size":360,"location":363},{"width":361,"height":362},864,486,{"bucket":294,"key":364},"\u002Fmigrated-images\u002FScreen Shot 2018-07-31 at 6.20.10 pm.png",{"id":366,"created":367,"updated":368,"published":367},471,1534094485,1655189586]