http://www.sccm.org/Documents/SSC-Guidelines.pdf
Page 5. and sorry its a 1c not 1a I was incorrect there. Repeated measuresments of CVP and SvO2/ScvO2/MAP are recommended throught out the resussitation period (first 6). I suppose you could rely on your cuff for map, again there is recent literature in SCCM i wil dig up for you showing it as inferior in the ICE setting to invasie BP monitoring, and you cpuld ECHO/US for CVP every 30 minutes while you are bolusing to goal, and you can draw venous gases continuously while titrating ionotropes/giving blood.....or you can thow in an art line and a cvc in <8 minutes and have all those continuosuly... I guess whatever floats your boat. If you have time to go in an reimage for CVP every 30 minutes for 3 hours while you are giving them volume, I would imagine a line would have been faster, atleast for me it definitely would.
And I should clarify. Not in all forms of shock. Anyone getting a vasopressor for any type of shock should have the pressor titrated off an art line, they are actually relatively benign with normal coags and a proper allen test, again, this is based off data showing superiority in an ICU setting to invasive BP monitoring. And no pressor shouls run through a peripheral. So, if you extrapolate, any patient in shock, that is to sayy hypotension refractory to appropriate volume resussitation, thus now requireing a pressor, should have a CVC and an art. And i said the art can slide til they get upstairs.
For the hemorragic shocks I actually prefer to see a 9 or 12 french short cordis in the chest/neck to a TLC, Pouseilles law obv. But thats still a CVC.
And PA pressures are quite useful in cardiogenic shock from AMI/massive PE. And I didnt say place a PA catheter, just said have a line in so that one could be placed if needed.