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CVICU
Rotations · CVICU · Quick Reference
This is a reference, never a protocol. The ranges and thresholds below are teaching values from published professional-society material — they are context-dependent markers, not treatment triggers, and no local dose or concentration appears here because that has to come from pharmacy.
Today
Resolved live from the schedule.
Shown on Overview, off the schedule’s own late-fellow rota.
Hemodynamics
Normal ranges. A trend beats any single value.
Right-sided filling pressure. Interpret with ventilation, TR, RV function and volume status.
Look for RV systolic pressure, diastolic equalization and RV failure patterns.
Systolic, diastolic and mean, plus the waveform morphology.
Read with PCWP and PVR, never alone.
Estimates left atrial pressure. Confirm a true wedge waveform and measure at end expiration.
The trend matters more than the number.
Below 2.2 is the classic low-output shock threshold when invasive data are obtained.
Oxygen delivery against extraction. Below 60% is concerning in a shock context.
Distinguishes vasodilatory from vasoconstricted physiology.
Pulmonary vascular load. Interpret with mPAP, PCWP and CO.
Teaching ranges — verify against current institutional protocol and local lab references
Derived indices
Low output below 2.2 in a cardiogenic shock context.
High in many cardiogenic phenotypes; low in distributive and mixed shock.
Expressed in Wood units.
Severe LV pump failure. Below 0.6 W is a commonly used high-risk threshold.
Low values suggest RV failure. Below 1.0 is a commonly used severe-RV-shock threshold.
A higher ratio suggests disproportionate RV failure. Above 0.63 is commonly cited as concerning.
Teaching ranges — verify against current institutional protocol and local lab references
SCAI shock stages
Re-stage serially. A rising stage is the trigger, not the label.
Normal perfusion. Generally SBP >100, CI ≥2.5 if acute, CVP ≤10, PCWP ≤15, PA sat ≥65%.
SBP <90, MAP <60, or a fall of more than 30 mmHg from baseline; often HR ≥100; lactate still normal.
Lactate ≥2; often CI <2.2 and PCWP >15 where invasive data exist; oliguria, cool extremities, altered mentation.
Rising or persistent lactate ≥2, worsening organ function, escalating pressors or MCS.
Severe hypotension, recurrent CPR or pressor boluses, severe acidosis; lactate may be ≥8, pH <7.2.
SCAI SHOCK 2022 update and bedside checklist
Bedside flags
Context-dependent markers. Not one of them is a treatment trigger on its own.
With instability. The threshold varies; use perfusion, not MAP alone.
A common shock screening criterion.
A hypoperfusion marker. The serial trend is what matters.
Used in stage C bedside criteria. Interpret by size and renal function.
The classic low-output shock threshold.
Suggests an elevated left filling pressure in a shock context.
A high-risk LV pump failure marker.
Concerning for severe RV failure in a shock context.
A concerning delivery-to-extraction imbalance.
High right-sided filling pressure. Context-dependent.
Supports disproportionate RV failure when paired with other findings.
SCAI SHOCK 2022 update and bedside checklist
Urgent
Local shock-team activation criteria, the number or pager, and the sequence.
Answered by: Program
The local ECMO activation workflow and the responsible team.
Answered by: Program
The emergency CT surgery contact, and where its coverage is published.
Answered by: Program
The STEMI activation path and number.
Answered by: Program
The in-house rapid response and code numbers.
Answered by: Program
People
On-Shift Contacts, resolved from the Directory.
CVICU Attending
Dr. James E. LivesaySign in to viewHidden. Sign in to view.
CVICU Fellow
Dr. Jackson MosleySign in to viewHidden. Sign in to view.
Consults Fellow
Dr. Edward LeonardSign in to viewHidden. Sign in to view.
Wortham / Consults Attending
Dr. Peter R. ScottSign in to viewHidden. Sign in to view.
Interventional On-Call
Dr. James E. LivesaySign in to viewHidden. Sign in to view.
EP On-Call
Dr. Jeffrey B. HirshSign in to viewHidden. Sign in to view.
Cardiac Surgery
Not on the attending schedule
Shock / ECMO Escalation
No local pathway supplied
Restricted
Shown to fellows and the coordinator only.
Logins
What UTKardio will and will not hold.
- Cerner is an individual clinical login. UTKardio does not store a fellow’s Cerner password and never will.
- UConcall carries schedules and inpatient and procedure billing. No shared credential was supplied, and none should be.
- Any future shared credential lives server-side in restricted resources, behind the same permission check as a door code — see the rule in
AGENTS.md.
Still needed from the program
Listed rather than guessed. These are the facts this page cannot answer.
- Shock pathwayLocal shock-team activation criteria, the phone or pager, and the sequence.
- MedicationLocal vasoactive and antiarrhythmic concentrations and dosing protocols, if the program wants them here at all.
Last updated 2026-09-19 · Program, CVICU Work Guide specification, 2026-09-19
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