Certified Emergency Manager (CEM) Exam Study Guide & Practice
Questions 2025
State of impaired tissue
perfusion resulting from Shock
circulatory failure.
Decreased cellular perfu-
sion secondary to lack of
Hypovolemic Shock
circulating volume or not
ENOUGH GAS.
Decreased cellular perfu-
sion secondary to maldis-
tribution of oxygen to the
periphery. Its like adding Cardiogenic Shock
a larger engine without in-
creasing the size of the
tank.
Decreased cellular perfu-
sion secondry to obstruc-
tion of blood into or out
of the ventricles (eg. pul-
Obstructive shock
monary emboli, tampon-
ade, tension pneumo. Like
getting dirt or blockage in
the fuel line.
Prolonged lactic acidosis
leads to:
, Certified Emergency Manager (CEM) Exam Study Guide & Practice
Questions 2025
microvascular thrombosis
disseminated intravascu-
lar coagulation (DIC)
When patient is able to
maintain blood pressure.
Body attempting to main-
tain homeostasis. Increas- Compensated Shock
es perfusion to brain, de-
creases blood flow to kid-
neys.
Shock at cellular level. In-
tracellular fluid leaks into
interstitium causing third
Uncompensated Shock
spacing and edema, bp
decreases, hr increases,
respiratory rate increases,
Blood or fluid loss reduces
circulating blood volume Hypovolemic Shock
and cardiac output.
MAP = (Systolic pressure
+ 2(Diastolic) / 3 Mean Arterial Pressure
Want a MAP above 60
Airway control, control
bleeing or fluid loss, re-
, Certified Emergency Manager (CEM) Exam Study Guide & Practice
Questions 2025
store volume, NS 0.9%,
Adult 1-2L bolus, Pedi Hypovolemic shock inter-
20ml/kg. Never use Dex- ventions
trose
Inadequate tissue perfu-
sion as a result of de-
creased cardiac output de-
Cardiogenic Shock
spite adequate intravascu-
lar volume. Most common
is MI. Pump Failure
Airway with PEEP will
force pulmonary edema
fluid out of the lung in-
Cardiogenic Shock Inter-
terstitium. Decrease pre-
ventions
load by position, nitro, di-
uretics, morphine. Cardiac
cath, angioplasty.
Abnormal distribution of in-
travascular volume. Can
Distributive Shock
me anaphylactic, septic,
neurogenic
Acute life threatening aller-
Distributive Shock (Ana-
gic reaction to individuals
phylaxis)
exposed to an antigen to
, Certified Emergency Manager (CEM) Exam Study Guide & Practice
Questions 2025
which they have become
hypersensitive.
IM epi 1:1000 repeat in
15-20 min as needed. Al- Anaphylactic Shock Inter-
buterol, H1 abd H2 block- ventions
ers, Corticosteroids.
Systemic Inflammatory re-
sponse syndrome (SIRS).
Sepsis with organ dysfunc-
tion, cardio failure lead-
ing to hypotension, Resp
Septic Shock
failure leading to hypox-
ia, Renal failure leading
to oliguria and azotemia.
MODS, multiple organ dys-
fumction syndrome.
Positive inotropes, vaso-
Septic Shock Interven-
pressors, fluid resuscita-
tions
tion, antibiotics
Loss of the sympathetic
nervous system "fight or
flight" response is lost and Neurogenic Shock
the rest of digest system
is unopposed. Bradycar-
Questions 2025
State of impaired tissue
perfusion resulting from Shock
circulatory failure.
Decreased cellular perfu-
sion secondary to lack of
Hypovolemic Shock
circulating volume or not
ENOUGH GAS.
Decreased cellular perfu-
sion secondary to maldis-
tribution of oxygen to the
periphery. Its like adding Cardiogenic Shock
a larger engine without in-
creasing the size of the
tank.
Decreased cellular perfu-
sion secondry to obstruc-
tion of blood into or out
of the ventricles (eg. pul-
Obstructive shock
monary emboli, tampon-
ade, tension pneumo. Like
getting dirt or blockage in
the fuel line.
Prolonged lactic acidosis
leads to:
, Certified Emergency Manager (CEM) Exam Study Guide & Practice
Questions 2025
microvascular thrombosis
disseminated intravascu-
lar coagulation (DIC)
When patient is able to
maintain blood pressure.
Body attempting to main-
tain homeostasis. Increas- Compensated Shock
es perfusion to brain, de-
creases blood flow to kid-
neys.
Shock at cellular level. In-
tracellular fluid leaks into
interstitium causing third
Uncompensated Shock
spacing and edema, bp
decreases, hr increases,
respiratory rate increases,
Blood or fluid loss reduces
circulating blood volume Hypovolemic Shock
and cardiac output.
MAP = (Systolic pressure
+ 2(Diastolic) / 3 Mean Arterial Pressure
Want a MAP above 60
Airway control, control
bleeing or fluid loss, re-
, Certified Emergency Manager (CEM) Exam Study Guide & Practice
Questions 2025
store volume, NS 0.9%,
Adult 1-2L bolus, Pedi Hypovolemic shock inter-
20ml/kg. Never use Dex- ventions
trose
Inadequate tissue perfu-
sion as a result of de-
creased cardiac output de-
Cardiogenic Shock
spite adequate intravascu-
lar volume. Most common
is MI. Pump Failure
Airway with PEEP will
force pulmonary edema
fluid out of the lung in-
Cardiogenic Shock Inter-
terstitium. Decrease pre-
ventions
load by position, nitro, di-
uretics, morphine. Cardiac
cath, angioplasty.
Abnormal distribution of in-
travascular volume. Can
Distributive Shock
me anaphylactic, septic,
neurogenic
Acute life threatening aller-
Distributive Shock (Ana-
gic reaction to individuals
phylaxis)
exposed to an antigen to
, Certified Emergency Manager (CEM) Exam Study Guide & Practice
Questions 2025
which they have become
hypersensitive.
IM epi 1:1000 repeat in
15-20 min as needed. Al- Anaphylactic Shock Inter-
buterol, H1 abd H2 block- ventions
ers, Corticosteroids.
Systemic Inflammatory re-
sponse syndrome (SIRS).
Sepsis with organ dysfunc-
tion, cardio failure lead-
ing to hypotension, Resp
Septic Shock
failure leading to hypox-
ia, Renal failure leading
to oliguria and azotemia.
MODS, multiple organ dys-
fumction syndrome.
Positive inotropes, vaso-
Septic Shock Interven-
pressors, fluid resuscita-
tions
tion, antibiotics
Loss of the sympathetic
nervous system "fight or
flight" response is lost and Neurogenic Shock
the rest of digest system
is unopposed. Bradycar-
