Shock: Four Categories, RUSH Exam, Vasopressor Selection & ED Resuscitation | EM Board Mastery

Shock in the emergency department — from recognition to resuscitation. The four hemodynamic categories (hypovolemic, distributive, cardiogenic, obstructive), MAP and lactate as bedside markers, the RUSH ultrasound exam, balanced crystalloid vs no-bolus decisions, vasopressor selection (norepinephrine, epinephrine, vasopressin, dobutamine, phenylephrine), mechanical support, REBOA, source control, and pediatric considerations. Three case anchors: septic shock in an elderly patient, cardiogenic shock post-MI, anaphylactic shock. Presented by Ezekiel Shepard, M.D. Shepard EM Board Mastery — Rosen's Series. Comprehensive Rosen's Emergency Medicine chapter-by-chapter board review for residents, attendings, and senior medical students preparing for ABEM, ITE, and USMLE Step exams. ⏱ CHAPTERS 0:03 Cold Open BP Cuff 0:19 Question Reveal 0:36 Three Steps 1:06 Case 1 Septic Elderly 1:43 Case 2 Cardiogenic MI 2:19 Case 3 Anaphylaxis 2:52 What Shock Is 3:22 MAP 3:56 Normotensive Shock 4:26 Empirical Criteria 4:57 Bedside Markers 5:26 Cap Refill Mottling 6:02 Lactate 6:45 Four Categories 7:24 Hemodynamic Profile 8:16 Septic Distributive 8:54 Anaphylactic Neurogenic 9:38 Hypovolemic Hemorrhagic 10:14 Cardiogenic Obstructive 10:52 RUSH Five Windows 11:29 Heart Window 12:07 IVC Window 12:50 Morrisons Aorta PTX 13:24 Balanced Crystalloid 14:07 Cardiogenic No Bolus 14:42 Anaphylaxis Epi First 15:20 30 mL kg Debate 16:01 Passive Leg Raise 16:39 Stop Fluid 17:12 Vasopressor Selection 17:49 Norepinephrine 18:28 Epinephrine 19:15 Vasopressin 19:52 Dobutamine 20:27 Phenylephrine 21:02 Dopamine Wrong 21:36 Peripheral Pressors 22:13 Mechanical Support 23:00 REBOA 23:37 Source Control 24:16 Peds Shock 24:55 Cold vs Warm Peds 25:35 Disposition 26:13 Pitfalls 27:00 Ten Things 28:24 Documentation 28:59 Cliffhanger Close 📚 ABOUT THIS SERIES Shepard EM Board Mastery covers Rosen's Emergency Medicine chapter-by-chapter with board-prep depth, case-first pedagogy, and explicit traps and pearls. Built for residents preparing for boards and clinicians refining shift-level reasoning. 🎓 REFERENCES Content informed by Rosen's Emergency Medicine (10th edition), Surviving Sepsis Campaign guidelines, SOAP II (NEJM 2010), CENSER (Lancet 2019), and current society guidelines on shock management. ⚠ DISCLAIMER This content is for educational purposes only. It does not replace clinical judgment, institutional protocols, or specialty consultation. Always follow your local guidelines and consult appropriate specialists. #EmergencyMedicine #BoardReview #Shock #Sepsis #ShepardEMBoardMastery