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TRAUMA ICU ROUNDS
Explore All Topics
Trauma Resuscitation
Airway & Mechanical Ventilation
Shock & Hemodynamics
Neurocritical Care & TBI
Acute Care Surgery & EGS
Surgical Critical Care
Leadership & Trauma Systems
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About
Resources
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Trauma Resuscitation
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Shock & Hemodynamics
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About
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Leadership & Systems Dennis Kim 6/25/21 Leadership & Systems Dennis Kim 6/25/21

Modern Insights into an Academic Career in Trauma & Acute Care Surgery with Dr. Carlos Brown

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Emergency General Surgery & ACS Dennis Kim 6/7/21 Emergency General Surgery & ACS Dennis Kim 6/7/21

Massive Upper GI Bleeds

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Trauma Resuscitation, Shock & Hemodynamics Dennis Kim 6/7/21 Trauma Resuscitation, Shock & Hemodynamics Dennis Kim 6/7/21

Penetrating Cardiac Injuries with Dr. Kenji Inaba

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Emergency General Surgery & ACS Dennis Kim 6/7/21 Emergency General Surgery & ACS Dennis Kim 6/7/21

Management of the Difficult Gallbladder

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Emergency General Surgery & ACS, Surgical Critical Care Dennis Kim 6/7/21 Emergency General Surgery & ACS, Surgical Critical Care Dennis Kim 6/7/21

Acute Colonic Pseudo-Obstruction (aka Ogilvie's Syndrome)

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Emergency General Surgery & ACS Dennis Kim 6/7/21 Emergency General Surgery & ACS Dennis Kim 6/7/21

Acute Mesenteric Ischemia

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Emergency General Surgery & ACS Dennis Kim 6/7/21 Emergency General Surgery & ACS Dennis Kim 6/7/21

Necrotizing Soft Tissue Infections

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Airway & Mechanical Ventilation Dennis Kim 6/7/21 Airway & Mechanical Ventilation Dennis Kim 6/7/21

Cricothyrotomy Considerations with Scott Weingart

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Airway & Mechanical Ventilation Dennis Kim 6/7/21 Airway & Mechanical Ventilation Dennis Kim 6/7/21

Basic Mechanical Ventilation III: The Role of PEEP & LVRs

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Airway & Mechanical Ventilation Dennis Kim 6/7/21 Airway & Mechanical Ventilation Dennis Kim 6/7/21

ARDS Fundamentals I: Classification, Pathophysiology & Initial Vent Management

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Leadership & Systems Dennis Kim 6/7/21 Leadership & Systems Dennis Kim 6/7/21

Sleep, Wellness, and the Acute Care Surgeon

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Emergency General Surgery & ACS Dennis Kim 6/7/21 Emergency General Surgery & ACS Dennis Kim 6/7/21

Bowel Obstruction & the Role of the Gastrografin Challenge

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Trauma Resuscitation, Shock & Hemodynamics Dennis Kim 6/7/21 Trauma Resuscitation, Shock & Hemodynamics Dennis Kim 6/7/21

Harbor-UCLA Anesthesia Grand Rounds “Resuscitative Thoracotomy (& some stuff on crics)”

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Neurocritical Care & TBI, Trauma Resuscitation Dennis Kim 6/7/21 Neurocritical Care & TBI, Trauma Resuscitation Dennis Kim 6/7/21

Blunt Cerebrovascular Injury (BCVI)

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Trauma Resuscitation Dennis Kim 6/7/21 Trauma Resuscitation Dennis Kim 6/7/21

Who Should Manage Vascular Trauma?

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Surgical Critical Care Dennis Kim 6/7/21 Surgical Critical Care Dennis Kim 6/7/21

Acute Kidney Injury (AKI) in the SICU with kidney_boy aka Dr. Joel Topf

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Surgical Critical Care Dennis Kim 6/7/21 Surgical Critical Care Dennis Kim 6/7/21

Sepsis 2020: What Surgeons Need to Know

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Emergency General Surgery & ACS Dennis Kim 6/7/21 Emergency General Surgery & ACS Dennis Kim 6/7/21

Extremity Compartment Syndrome

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Dennis Kim 6/7/21 Dennis Kim 6/7/21

Acute Care Surgery

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Dennis Kim 6/7/21 Dennis Kim 6/7/21

Season 1 Recap

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Older Posts

COMMON TRAPS

Equating hypotension with shock

Blood pressure does not define tissue perfusion.

Giving fluid because the patient is hypotensive

The dominant problem may be pump, flow, or tone.

Treating lactate as the diagnosis

Lactate is a signal.

It is not a mechanism.

Assuming only one shock phenotype

Mixed shock is common.

Escalating vasopressors without reassessing cardiac function

A higher MAP does not necessarily mean better circulation.

Continuing an intervention without testing the response

Every intervention should generate another question:

Did it work?

WATCH THE EPISODE

Shock Is Not Just Hypotension: What Most Clinicians Miss

In this episode of Trauma ICU Rounds, we work through a practical framework for recognizing shock, understanding oxygen delivery, identifying the major shock phenotypes, using POCUS, assessing fluid responsiveness, and choosing interventions based on physiology rather than blood pressure alone.

Watch on YouTube
https://youtu.be/GU9739FLXrU

DOWNLOAD THE SHOCK POCKET PLAYBOOK

A one-page bedside reference covering:

  • recognition of shock

  • Volume • Pump • Flow • Tone

  • the first 5–10 minutes

  • POCUS questions

  • fluid responsiveness

  • Don’t Chase the MAP

  • diagnoses not to miss

Download the Pocket Playbook

ROUNDS BOTTOM LINE

SHOCK IS A PHYSIOLOGIC DIAGNOSIS

Recognize impaired perfusion.

Identify the dominant mechanism.

Treat volume, pump, flow or tone.

Then reassess whether oxygen delivery and tissue perfusion actually improved.

CONTINUE ON TRAUMA ICU ROUNDS

Damage Control Resuscitation

Control the bleeding. Preserve physiology. Buy time for hemostasis.

Explore DCR

Hemorrhage & Resuscitation

Practical frameworks for bleeding, blood products and physiologic resuscitation.

Explore Topic

Trauma ICU Rounds

Practical, evidence-based trauma and critical care for clinicians managing critically ill patients.

Watch More Episodes

TRAUMA ICU ROUNDS

Think Clearly. When Minutes Matter.

Dennis Kim, MD
Trauma Surgeon · Intensivist · Medical Educator

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