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Emphasizing multidisciplinary team-based care and data-driven insights, the paper details optimal strategies for managing cardiogenic shock from initial contact, noting challenges in prehospital identification and treatment due to patient and disease heterogeneity and the variability in response capabilities of prehospital teams.<\/jats:p>","DOI":"10.15420\/usc.2025.16","type":"journal-article","created":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T09:52:18Z","timestamp":1788429138000},"source":"Crossref","is-referenced-by-count":2,"title":["Cardiogenic Shock Systems of Care Best Practices. Part 1: Prehospital and Emergency Department Evaluation and Management"],"prefix":"10.15420","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5157-2610","authenticated-orcid":false,"given":"Michael J","family":"Lauria","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/00cvxb145","id-type":"ROR","asserted-by":"publisher"}],"name":"University of Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8250-5149","authenticated-orcid":false,"given":"Adam L","family":"Gottula","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/017zqws13","id-type":"ROR","asserted-by":"publisher"}],"name":"University of Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-8353-5077","authenticated-orcid":false,"given":"William","family":"Hallinan","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/017zqws13","id-type":"ROR","asserted-by":"publisher"}],"name":"University of Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-1037-7878","authenticated-orcid":false,"given":"Eric","family":"Thomas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4628-6852","authenticated-orcid":false,"given":"Katherine L","family":"Wood","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3486-6753","authenticated-orcid":false,"given":"Mir B","family":"Basir","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/02kwnkm68","id-type":"ROR","asserted-by":"publisher"}],"name":"Henry Ford Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5656-4401","authenticated-orcid":false,"given":"Alexander G","family":"Truesdell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3539-7696","authenticated-orcid":false,"given":"Kari L","family":"Gorder","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/02hsexy86","id-type":"ROR","asserted-by":"publisher"}],"name":"Riverside Methodist Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"6096","published-online":{"date-parts":[[2026,9,22]]},"reference":[{"key":"ref0","doi-asserted-by":"crossref","unstructured":"Sterling LH, Fernando SM, Talarico R, et al. 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Management of acute dyspnoea: use and feasibility of brain natriuretic peptide (BNP) assay in the prehospital setting. Resuscitation 2004;61:91\u20136. https:\/\/doi.org\/10.1016\/j.resuscitation.2003.12.005; PMID: 15081187. DOI: 10.1016\/j.resuscitation.2003.12.005","DOI":"10.1016\/j.resuscitation.2003.12.005"},{"key":"ref22","doi-asserted-by":"crossref","unstructured":"Standifird C, Wassermann M, Lauria MJ. Initiation of invasive arterial pressure monitoring by critical care transport crews. Air Med J 2022;41:248\u201351. https:\/\/doi.org\/10.1016\/j.amj.2021.11.006; PMID: 35307152. DOI: 10.1016\/j.amj.2021.11.006","DOI":"10.1016\/j.amj.2021.11.006"},{"key":"ref23","doi-asserted-by":"crossref","unstructured":"Murray A, Hutchison H, Popil M, Krebs W. The use of point-of-care ultrasound to accurately measure cardiac output in flight. Air Med J 2020;39:218\u201320. https:\/\/doi.org\/10.1016\/j.amj.2019.12.008; PMID: 32540116. 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Inotropic agents and vasodilator strategies for the treatment of cardiogenic shock or low cardiac output syndrome. Cochrane Database Syst Rev 2020;11:CD009669. https:\/\/doi.org\/10.1002\/14651858.CD009669.pub4; PMID: 33152122. DOI: 10.1002\/14651858.CD009669.pub4","DOI":"10.1002\/14651858.CD009669.pub4"},{"key":"ref32","doi-asserted-by":"crossref","unstructured":"Gorder K, Rudick S, Smith TD. Advocacy and legislation for regionalization practices in the treatment of cardiogenic shock: the time is now. US Cardiol 2022;16:e06. https:\/\/doi.org\/10.15420\/usc.2021.14; PMID: 39600852. DOI: 10.15420\/usc.2021.14","DOI":"10.15420\/usc.2021.14"},{"key":"ref33","doi-asserted-by":"crossref","unstructured":"Tchantchaleishvili V, Hallinan W, Massey HT. Call for organized statewide networks for management of acute myocardial infarction-related cardiogenic shock. JAMA Surg 2015;150:1025\u20136. https:\/\/doi.org\/10.1001\/jamasurg.2015.2412; PMID: 26375168. DOI: 10.1001\/jamasurg.2015.2412","DOI":"10.1001\/jamasurg.2015.2412"},{"key":"ref34","doi-asserted-by":"crossref","unstructured":"Kontos MC, Gunderson MR, Zegre-Hemsey JK, et al. Prehospital activation of hospital resources (PreAct) ST-segment-elevation myocardial infarction (STEMI): a standardized approach to prehospital activation and direct to the catheterization laboratory for STEMI recommendations from the American Heart Association\u2019s Mission: Lifeline program. J Am Heart Assoc 2020;9:e011963. https:\/\/doi.org\/10.1161\/JAHA.119.011963; PMID: 31957530. DOI: 10.1161\/JAHA.119.011963","DOI":"10.1161\/JAHA.119.011963"},{"key":"ref35","unstructured":"Washington State Department of Health. State of Washington prehospital cardiac triage destination procedure. https:\/\/www.doh.wa.gov\/Portals\/1\/Documents\/Pubs\/346050.pdf (accessed April 1, 2024)."},{"key":"ref36","doi-asserted-by":"crossref","unstructured":"Lim HS. Cardiogenic shock: failure of oxygen delivery and oxygen utilization. Clin Cardiol 2016;39:477\u201383. https:\/\/doi.org\/10.1002\/clc.22564; PMID: 27509355. DOI: 10.1002\/clc.22564","DOI":"10.1002\/clc.22564"},{"key":"ref37","doi-asserted-by":"crossref","unstructured":"Reynolds HR, Hochman JS. Cardiogenic shock: current concepts and improving outcomes. Circulation 2008;117:686\u201397. https:\/\/doi.org\/10.1161\/CIRCULATIONAHA.106.613596; PMID: 18250279. DOI: 10.1161\/CIRCULATIONAHA.106.613596","DOI":"10.1161\/CIRCULATIONAHA.106.613596"},{"key":"ref38","doi-asserted-by":"crossref","unstructured":"Shirakabe A, Matsushita M, Shibata Y, et al. Organ dysfunction, injury, and failure in cardiogenic shock. J Intensive Care 2023;11:26. https:\/\/doi.org\/10.1186\/s40560-023-00676-1; PMID: 37386552. DOI: 10.1186\/s40560-023-00676-1","DOI":"10.1186\/s40560-023-00676-1"},{"key":"ref39","doi-asserted-by":"crossref","unstructured":"Gheorghiade M, De Luca L, Fonarow GC, et al. Pathophysiologic targets in the early phase of acute heart failure syndromes. Am J Cardiol 2005;96:11G\u20137G. https:\/\/doi.org\/10.1016\/j.amjcard.2005.07.016; PMID: 16196154. DOI: 10.1016\/j.amjcard.2005.07.016","DOI":"10.1016\/j.amjcard.2005.07.016"},{"key":"ref40","doi-asserted-by":"crossref","unstructured":"Henry TD, Tomey MI, Tamis-Holland JE, et al. Invasive management of acute myocardial infarction complicated by cardiogenic shock: a scientific statement from the American Heart Association. Circulation 2021;143:e815\u201329. https:\/\/doi.org\/10.1161\/CIR.0000000000000959; PMID: 33657830. DOI: 10.1161\/CIR.0000000000000959","DOI":"10.1161\/CIR.0000000000000959"},{"key":"ref41","unstructured":"McDonagh TA, Metra M, Adamo M, et al. 2021 ESC guidelines for the diagnosis and treatment of acute and chronic heart failure: developed by the Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC) with the special contribution of the Heart Failure Association (HFA) of the ESC. Rev Esp Cardiol (Engl Ed) 2022;75:523. https:\/\/doi.org\/10.1016\/j.rec.2022.05.005; PMID: 35636830."},{"key":"ref42","unstructured":"Basir MB, Schreiber T, Dixon S, et al. Feasibility of early mechanical circulatory support in acute myocardial infarction complicated by cardiogenic shock: the Detroit cardiogenic shock initiative. Catheter Cardiovasc Interv 2018;91:454\u201361. https:\/\/doi.org\/10.1002\/ccd.27427; PMID: 29266676."},{"key":"ref43","doi-asserted-by":"crossref","unstructured":"Jones TL, Nakamura K, McCabe JM. Cardiogenic shock: evolving definitions and future directions in management. Open Heart 2019;6:e000960. https:\/\/doi.org\/10.1136\/openhrt-2018-000960; PMID: 31168376. DOI: 10.1136\/openhrt-2018-000960","DOI":"10.1136\/openhrt-2018-000960"},{"key":"ref44","doi-asserted-by":"crossref","unstructured":"Eckstein M, Suyehara D. Ability of paramedics to treat patients with congestive heart failure via standing field treatment protocols. Am J Emerg Med 2002;20:23\u20135. https:\/\/doi.org\/10.1053\/ajem.2002.30106; PMID: 11781907. DOI: 10.1053\/ajem.2002.30106","DOI":"10.1053\/ajem.2002.30106"},{"key":"ref45","doi-asserted-by":"crossref","unstructured":"Roth RN, Fowler RL, Guyette FX. Hypotension and shock. In: Cone DC, Brice JH, Delbridge TR, Myers JB, eds. Emergency Medical Services: Clinical Practice and Systems Oversight. Chichester: Wiley, 2015;67\u201377. https:\/\/doi.org\/10.1002\/9781118990810.ch7. 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