Cardiogenic Shock

Indications: A return of circulation post cardiac arrest (ROSC) or a 12 lead ECG indicating a STEMI and signs of cardiogenic shock and is ≥ 2 years of age.

0.9% NaCl: If hypotensive and chest auscultation is clear infuse 10ml/kg to a maximum volume of 1000ml.

Reassess every 100mls for patients < 12 years of age and every 250mls for patients ≥ 12 years of age.

Dopamine: If patient is hypotensive and does not have an allergy or sensitivity to dopamine, is not in a tachydysrhythmia or a mechanical shock state, is not hypovolemic and does not suffer from pheochromocytoma infuse Dopamine at an initial rate of 5mcg/kg/min IV.

Titrate every 5 minutes by 5mcg/kg/min to a maximum infusion rate of 20mcg/kg/min.

Note: Titrate dopamine to achieve a systolic BP of 90-110 mmHg.  If you elect to discontinue dopamine, do so gradually over 5 to 10 minutes.