Pediatric Shock

Question 1

Pediatric Shock - Known congenital heart disease resuscitation requires?

Answer 1

Mandatory OLMC prior to fluid challenge

Question 2

Pediatric Shock - Minimum blood pressure

Answer 2

BP 70 + (2 x age) mmHg

Question 3

Pediatric Shock - DDx to consider

Answer 3

Hemorrhage
Anaphylaxis
Tension Pneumothorax
Hyperglycemia

Question 4

Pediatric Shock - Fluid resuscitation

Answer 4

20ml/kg reassess lung sounds after each bolus, Maximum of 60ml/kg

Question 5

Pediatric Shock - Fluid resuscitation goals

Answer 5

Normal mentation
Normal capillary refill
Strong peripheral pulses
Adequate BP for age

Question 6

Pediatric Shock - Persistent shock criteria

Answer 6

Hypotension with or without:
Altered LOC
Weak peripheral pulses

Question 7

Pediatric Shock - Persistent shock treatment?

Answer 7

Mandatory OLMC to consider fluid or pressors

Question 8

Pediatric Shock - Epinephrine indications

Answer 8

Hypotension in shock refractory to fluid

Question 9

Pediatric Shock - Epinephrine dose

Answer 9

0.05 mcg/kg/min, Max 0.5 mcg/kg/min

Titrate to effect q 2 min - follow infusion chart

Question 10

Pediatric Shock - Epinephrine EMS contraindications

Answer 10

None

Question 11

Pediatric Shock - Epinephrine infusion set-up for 3-20 kgs

Answer 11

0.75 mg in 250 ml NS = 3 mcg/ml

Use 60 gtt set and control a flow

Question 12

Pediatric Shock - Epinephrine infusion set-up for 20-50 kgs

Answer 12

1.5 mg in 250 ml NS = 6 mcg/ml

Use 60 gtt set and control a flow

Question 13

Pediatric Shock - Epinephrine infusion concentrations for weight groups

Answer 13

3-20 kg = 3 mcg/ml

20-50 kg = 6 mcg/ml