In an age when we are held to a higher standard of being "Better, Faster, and Surer," the sheer volume, increasing complexity, and higher acuity of ED patients make the management of patients more challenging than ever before. The early recognition of clinical hypotension, the rapid initiation of goal directed resuscitation, and the early use of accurate diagnostic tools remain the cornerstone to reducing morbidity and mortality of hypotensive patients. Rapid identification of clinical hypotension should be followed by the rapid and confident diagnosis of the primary and contributory etiologies. The correction of the primary disorders must occur in parallel to the diagnostic workup to avoid adverse patient outcomes a rather tall order for the EM physician. Using the tools that are available to us early, before further deterioration of the critically ill patient, puts us one step closer to achieving that goal.
Anthony J. Weekes; Ryan J. Zapata; Antonio Napolitano
November 1, 2007