ALGORITHM FOR DISTRIBUTIVE SHOCK

Distributive shock, commonly caused by sepsis or anaphylaxis, involves abnormal vasodilation and maldistribution of blood flow, leading to inadequate tissue perfusion.

Signs of Distributive Shock:

• Bounding pulses and warm extremities in early stages.
• Hypotension and poor perfusion in late stages.
• Altered mental status.

Management Algorithm:

• Step 1: Administer high-flow oxygen.
• Step 2: Establish vascular access and give 20 mL/kg fluid boluses.
• Step 3: Administer vasopressors (e.g., epinephrine for anaphylaxis, norepinephrine for septic shock) if perfusion does not improve with fluids.
• Step 4: Treat the underlying cause:
  • Sepsis: Start broad-spectrum antibiotics.
  • Anaphylaxis: Administer intramuscular epinephrine and adjunct therapies such as antihistamines and corticosteroids.

Timely interventions tailored to the underlying cause can rapidly stabilize distributive shock.