Interactive tool · NMCSN Assessment & Management pathway

Shock Staging Tool

Stages a patient using the criteria in the NMCSN Cardiogenic Shock Assessment & Management pathway (Version 2.0, February 2026) and shows the reasoning, so the letter is never a black box. Runs entirely in your browser — nothing is stored or transmitted.

Decision support only — drawn from a manuscript under peer review. Criteria follow NMCSN Figure 2 (Yau et al., submitted to US Cardiology Review, 2026), which applies the CSWG operational approach to SCAI staging. Thresholds may change on publication. This tool does not replace clinical judgment or your institution's protocol.
The algorithm this tool runs — CS Assessment & Management, Figure 2 · tap the figure to enlarge
NMCSN Cardiogenic Shock Assessment and Management pathway — stages B, C and D/E with hemodynamic assessment, etiology-specific treatment, device escalation and ICU management.

Version 2.0, February 2026 · open full resolution →

Step 1 · Hemodynamics

Blood pressure

The activation trigger is SBP <90 sustained ≥15 minutes. MAP is computed.

MAP
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Step 2 · Labs

Lactate and pH

Lactate >2 marks hypoperfusion; lactate ≥5 and pH <7.2 are severe-stage criteria.

Step 3 · Support running

Vasoactives and devices

Select everything currently running.

1 vasopressor
≥2 vasopressors
Inotrope
pVAD (Impella)
VA-ECMO
Step 4 · Optional — invasive numbers

PA catheter values

Unlocks CPO, PAPi and the ICU wean / monitor / escalate branch. Pathway targets: CPO ≥0.6 W, lactate <4, reassessed every 6–12 hours.

CPO W
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PAPi
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ICU branch
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NMCSN PATHWAY STAGE
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Enter values to stage
Criteria met
  • Nothing entered yet.
Pathway action — Figure 2

Stage-specific actions appear here.

Always available
You do not need a diagnosis to call.

Suspected shock, a patient who looks bad, or a lactate you can't explain — call early.

1-888-727-7646 Level 1 Hub Transfer · Heart Hospital of New Mexico

No patient data leaves this page. Stage definitions: B — SBP <90 or lactate >2 · C — SBP <90 or on vasopressors and lactate >2 · D/E — lactate ≥5 and MAP <60 on ≥2 vasopressors ± MCS, or pH <7.2. CPO = MAP×CO/451 · PAPi = (PAs−PAd)/RA.