Name the predominant physiology. Treat it. Reassess.
ICU shock is usually mixed. EASy names the predominant physiology, ties it to a management pathway, and is fast enough to repeat after every intervention.
Shock in the ICU rarely reads as one textbook category. Sepsis arrives on top of a failing right ventricle; hypovolemia hides behind vasopressors. The practical question is not "which shock is this?" but "which physiology is predominant right now, and what do I do about it first?"
And the answer changes. A hemodynamic assessment that takes long enough to feel like a procedure gets done once. The assessments that actually steer an ICU course are the ones short enough to repeat after every fluid bolus, vasopressor change, and ventilator adjustment.
Acquire. Phenotype. Act.
Acquire
Heart, IVC, and anterior lungs from the subcostal-first window on one phased-array probe — with the exam bounded tightly enough that repeating it on rounds is realistic, not aspirational.
Phenotype
Findings resolve into one of ten hemodynamic phenotypes. In mixed shock, the phenotype names the predominant physiology — the thing to treat first — rather than forcing a single diagnosis the patient doesn't have.
Act
Each phenotype guides a defined pathway: fluid, vasopressor, inotrope, or drainage — then re-scan. The phenotype is a snapshot, and serial reassessment is the point, not an afterthought.
Where EASy fits in your unit
Average examination time for novice sonographers in the published comparison. A protocol that costs a quarter of the time gets repeated when the patient changes.
Fiorini & Basmaji, Can J Anaesth 2022After one day of focused training, novice residents obtained images sufficient for supervised clinical decision-making in 87% of 63 examinations, with a mean examination time of 4.3 minutes. Day one is about acquisition; interpretation stays supervised.
Crit Care Explor 2024Take it to the bedside
EASy MAP bedside tool
member accessScore image quality, walk the rule-out worksheet, and see the considerations that follow from the pattern.
OpenEASy Sepsis bedside tool
member accessSerial assessment and de-resuscitation support with a copyable session report.
OpenFree bedside cards
Print-ready phenotype and resuscitation reference for your unit's machines.
OpenTrain your team to read the unstable patient
Live, case-based courses for clinicians at every level — and a supervised pathway for programs building a POCUS curriculum.
Emergency Medicine Anesthesiology Hospital Medicine EMS & Prehospital Programs & Educators