#488: The Perfusion Problem: Why Your Patient is Deteriorating

About this episode

This episode explores the critical concept of perfusion in patient assessment and how to recognize signs of deterioration.

You know that moment when you walk into a patient’s room and something just feels… off? Not wrong in a pull-the-crash-cart way. Just… different. Their blood pressure is trending down a little. They’re not quite as sharp as they were two hours ago. Urine output isn’t great. And your brain starts doing that scrambling thing — flipping through every diagnosis you’ve ever learned, trying to figure out what category this falls into. Here’s the thing: that scrambling feeling? It’s not a sign that you don’t know enough. It’s a sign that you’re trying to find the diagnosis before you’ve found the pattern. This episode is about the pattern. Perfusion is one of those foundational concepts that shows up everywhere — cardiac, renal, neuro, sepsis, shock — and yet it rarely gets taught the way it needs to be. Not just “perfusion means blood flow” but what actually happens when it fails, how your patient’s body responds, and what that looks like when you’re standing at the bedside at 10am wondering if you need to make a phone call. In this episode, we go deep. Like, actually deep — the cellular level, the four components of the delivery system, why blood pressure is often the last thing to…

People in this episode

Host: Maureen Osuna

Topics covered

• patient assessment
• perfusion
• deterioration
• shock
• clinical cases

Keywords

• perfusion
• patient deterioration
• blood pressure
• shock types
• clinical assessment

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