ECMO and CV Director HCA Houston Healthcare Houston, Texas, United States
Disclosure(s):
Aiyasawmy D. Dorairajan, MD: No financial relationships to disclose
Background: The use of tabular Shock Boards to track hemodynamic parameters in diagnosis and on-going management of Cardiogenic Shock should lead to more precise decision making, and better clinical outcomes.
Methods: With the help of Abiomed, shock boards were printed and hung within every patient's room. Intensive education was done on all levels (Physicians, APPs, Bedside nurses, CV Education, etc) on how to appropriately collect data (Arterial Pressures, CVP, Pulmonary pressures, SvO2, etc) and then calculate hemodynamics (CO/CI using Fick, SVR, PVR, CPO, API, PAPI). Protocols were put into place as to which patient's we track, and what intervals we calculate hemodynamics. And with a Physican lead and CV Education nursing lead, shock boards were put into practice.
Outcome: All providers noted increase in proficiency in understanding hemodynamics of Cardiogenic Shock. Inotrope and Vasopressor management consistency improved across the board of providers. Bedside nurses became first line of defense for diagnosing developing cardiogenic shock and activating our shock hotline.
Conclusion: 12 months into the use, the Shock Boards have had a monumental impact on the precise and calculated management practices of Cardiogenic Shock within our institution.
