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

The Past, Present, and Future of REBOA

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

Hemodynamically Unstable Pelvic Fractures

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

UCLA Grand Rounds “Endpoints of Resuscitation: Where to Begin?”

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

Prehospital Tranexamic Acid (TXA) in Patients with Traumatic Brain Injury

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

Episode 15 - Emergency Preservation & Resuscitation for Cardiac Arrest from Trauma (EPR-CAT)

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

Circulation First: Rethinking the ABC Sequence of Initial Trauma Care

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

National Stop the Bleed Day & Tourniquet Use in 2020

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The Deadly Dozen of Thoracic Trauma
Trauma Resuscitation Dennis Kim 6/7/21 Trauma Resuscitation Dennis Kim 6/7/21

The Deadly Dozen of Thoracic Trauma

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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.

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Trauma ICU Rounds

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

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TRAUMA ICU ROUNDS

Think Clearly. When Minutes Matter.

Dennis Kim, MD
Trauma Surgeon · Intensivist · Medical Educator

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