Should we teach / use the Shock Index?

[Bernhard]

They taught me the shock index in advanced first responder class in my very beginning and made a big thing out if it, even beeing an item in the tests up to more advanced levels.

In the field I never used it directly or even calculated it on-scene, but I used the general comparision between heart rate and systolic blood pressure as one of many indicators that something may be going downhill. As others pointed out, there are several signs for that, a good one is a significant changing in continous monitor results, which includes heart rate and blood pressure.

After a bit research now I learned that the SI seems to be a more or less obsolete concept, generally speaking. OK, but I never did see it as a real value to be calculated on scene anyway, so I will not miss it.

Using it for teaching? Well, in a historical context, maybe yes. A lot of books/texts do mention the shock index, several studies and some algorithms do as well - so the student should know what it is. On the other hand I doubt it's usefulness in teaching something about the physiology of shock...the raising heart rate and dropping blood pressure or the simple fact that the two compared are giving an index is just one small part of the whole mechanism. And not a very reliable one. So, yes, teach it, but don't give it more meaning than it has.

[Steve Whitehead]

I appreciate that feedback Bernhard. Well thought out. Cogent. Non-polarizing. Experiential. Thank you.