Allgöwer M, Burri C. The “shock-index”. Dtsch med Wochenschr 1967; 92(43): 1947-1950. DOI: 10.1055/s-0028-1106070

Heffner AC, Swords DS, Neale MN, Jones AE. Incidence and factors associated with cardiac arrest complicating emergency airway management. Resuscitation. 2013;84(11):1500–1504.

Berger T, Green J, Horeczko T, et al. Shock Index and Early Recognition of Sepsis in the Emergency Department: Pilot Study. WestJEM. 2013;14(2):168–174.

ProCESS Investigators, Yealy DM, Kellum JA, et al. A randomized trial of protocol-based care for early septic shock. N Engl J Med. 2014;370(18):1683–1693.

Acker SN, Ross JT, Partrick DA, Tong S, Bensard DD. Pediatric specific shock index accurately identifies severely injured children. J Pediatr Surg. 2015;50(2):331-4.

Schroll R, Swift D, Tatum D, et al. Accuracy of shock index versus ABC score to predict need for massive transfusion in trauma patients. Injury. 2018;49(1):15-19.

Al Jalbout N, Balhara KS, Hamade B, Hsieh YH, Kelen GD, Bayram JD. Shock index as a predictor of hospital admission and inpatient mortality in a US national database of emergency departments. Emerg Med J. 2019;36(5):293-297.

Cannon CM, Braxton CC, Kling-Smith M, Mahnken JD, Carlton E, Moncure M. Utility of the Shock Index in Predicting Mortality in Traumatically Injured Patients. J Trauma. 2009;67(6):1426–1430.

Vandromme MJ, Griffin RL, Kerby JD, McGwin G Jr., Rue LW III, Weinberg JA. Identifying Risk for Massive Transfusion in the Relatively Normotensive Patient: Utility of the Prehospital Shock Index. J Trauma. 2011;70(2):384–390.

Mutschler M, Nienaber U, et al. The Shock Index revisited – a fast guide to transfusion requirement? A retrospective analysis on 21,853 patients derived from the TraumaRegister DGU®. Critical Care 2013, 17:R172 doi:10.1186/cc12851

Dr. Manuel Mutschler

Shock Index

heart_rate

systolic_blood_pressure

May be a more sensitive indicator of occult shock, especially in trauma or acute hemorrhage.

Sensitive indicator of occult shock.

Kamal (Kim) Medlej, MD, is an attending physician at the department of emergency medicine at Massachusetts General Hospital. He was born and raised in Beirut, Lebanon, then moved to Montreal to attend McGill University where he received his medical degree. He completed a residency in emergency medicine at St. Luke’s-Roosevelt Hospital Center in New York City and served as chief resident in his final year, followed by fellowship in critical care medicine at the Brigham and Women’s Hospital in Boston. Prior to joining the emergency department at MGH, Dr. Medlej was an attending physician in the emergency department of the American University of Beirut Medical Center in Lebanon then at Mount Sinai St. Luke's-West in New York City where he held appointments in both the emergency department and the division of pulmonary, critical care and sleep medicine. His areas of interest include emergency and critical care ultrasound, fluid management, non-invasive patient management, and the intersection of emergency medicine and critical care.

Kamal Medlej, MD

The Shock Index indicates level of occult shock, especially in trauma or acute hemorrhage, based on heart rate and systolic blood pressure.

Shock Index Calculator

Systolic BP

Heart Rate/Pulse

Predicts mortality in children with blunt trauma.

Shock Index, Pediatric Age-Adjusted (SIPA)

Predicts the need for massive transfusion based on clinical and laboratory data.

TASH Score

Predicts intracranial traumatic CT findings in patients with minor head trauma.

CHIP Prediction Rule

The American Academy of Pediatrics (AAP) focuses on the health, safety, and well-being of infants, children, and young adults. With about 67,000 members, including pediatricians, medical subspecialists, and surgical specialists, the AAP supports optimal care. Over 45,000 members are board-certified Fellows of the AAP (FAAP). Its mission is to promote children's health and well-being while supporting members' professional needs.

American Academy of Pediatrics (AAP)

The American Association for Physician Leadership&reg; (AAPL) is the world&rsquo;s oldest and largest professional association dedicated solely to maximizing physician leadership.&nbsp;From the moment physicians begin their leadership journey through the time they are seasoned leaders, AAPL provides education and training, resources and tools, and content and experiences needed to close gaps between hands-on clinical care, organization system improvements and optimized business outcomes.

American Association for Physician Leadership (AAPL)

American Association for the Study of Liver Diseases

The American College of Emergency Physicians (ACEP) represents more than 38,000 emergency physicians, emergency medicine residents and medical students. ACEP promotes the highest quality of emergency care and is the leading advocate for emergency physicians and their patients, and the public. Members may earn up to 850 continuing medical education hours every year through ACEP&rsquo;s robust catalog of peer-reviewed publications and on-demand courses presented by world-renowned emergency medicine experts.

American College Of Emergency Physicians

The American College of Gastroenterology (ACG) supports clinicians in delivering high-quality, evidence-based care to gastroenterology patients. Its mission is to advance care for those with gastrointestinal disorders through excellence, innovation, and advocacy. ACG provides members with up-to-date scientific information through annual meetings, the American Journal of Gastroenterology, training courses, and research grants, focusing on digestive health and GI disorder treatments.

American College of Gastroenterology

American College of Rheumatology

The American Gastroenterological Association (AGA), founded in 1897, provides leadership and education to over 16,000 members worldwide, all dedicated to advancing gastroenterology. The AGA&rsquo;s mission is to empower clinicians and researchers to improve digestive health through clinical guidance, practice resources, and peer-reviewed research. Key journals include Gastroenterology, Clinical Gastroenterology and Hepatology, Cellular and Molecular Gastroenterology and Hepatology, and others.

American Gastroenterological Association

American Heart Association

American Urological Association

EB Medicine is the premier provider of evidence-based clinical content and CME resources for emergency medicine practitioners.

EB Medicine

MDCalc Blog

MDCalc CME

Postgraduate Institute for Medicine

The Rome Foundation is a nonprofit organization dedicated to advancing the diagnosis and treatment of Disorders of Gut-Brain Interaction (DGBI), also known as functional gastrointestinal disorders. Its mission is to improve the lives of people with DGBI. For over 30 years, the Rome Foundation has worked with scientists and clinicians worldwide to classify and assess GI function and dysfunction, creating symptom-based criteria used in clinical trials and daily practice to guide diagnosis and treatment.

The ROME Foundation

Listen to the VACO co-creators break down how to use VACO\, what it does\, and what it doesn’t.