0 min in the ED:

  • Recognize decreased mental status and perfusion.
  • Begin high flow O2.
  • Establish IV/IO access.

5 min in the ED:

  • Initial resuscitation:
    • Push boluses of 20 cc/kg isotonic saline or colloid up to and over 60 cc/kg until perfusion impoved or rales/hepatomegaly develop.
    • Correct hypoglycemia and hypocalcaemia.
    • Begin antibiotics.
    • If 2nd PIV start inotrope.

15 min in the ED:

Is shock reversed?

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