What is patients mental status The body does all it can to

maintain perfusion to heart, brain, and adrenal glands in the face of hypotension or inadequate cardiac output. If mental status is not normal, assume that cerebral perfusion has been compromised. This represents an even more urgent medical emergency and may require immediate attention to airway as fluid resuscitation is occurring.

F. Are invasive monitors in place? If so, measuring central venous pressure (CVP) or wedge pressure provides an objective

TABLE I—12. LOWEST ACCEPTABLE SYSTOLIC BLOOD PRESSURE FOR AGE

Lowest Acceptable Systolic BP (mm Hg)

60 70

assessment of intravascular volume status. Patients should receive fluid resuscitation until CVP is > 10 cm H2O or wedge pressure is > 15 cm H2O. If this is achieved and patient remains hypotensive, consider use of inotropes or vasopressors.

G. Were any medications recently given? If patient has received any sedatives or analgesics that may affect Bp, this must be considered as the potential cause of hypotension. If so, antidotes may be given (eg, naloxone for opioids), but patient should still receive fluids. Consider an allergic reaction to any medication recently given.

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