David A. Wacker, Michael E. Winters

Research output: Contribution to journalReview articlepeer-review

14 Scopus citations


Critically ill patients with undifferentiated shock are complex and challenging cases in the ED. A systematic approach to assessment and management is essential to prevent unnecessary morbidity and mortality. The simplified, systematic approach described in this article focuses on determining the presence of problems with cardiac function (the pump), intravascular volume (the tank), or systemic vascular resistance (the pipes). With this approach, the emergency physician can detect life-threatening conditions and implement time-sensitive therapy.

Original languageEnglish (US)
Pages (from-to)747-758
Number of pages12
JournalEmergency Medicine Clinics of North America
Issue number4
StatePublished - Nov 1 2014

Bibliographical note

Publisher Copyright:
© 2014 Elsevier Inc.


  • Acute myocardial infarction
  • Anaphylaxis
  • Cardiac tamponade
  • Hemorrhage
  • Hypovolemia
  • Massive pulmonary embolism
  • Shock
  • Tension pneumothorax


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