The only way to defeat pediatric shock is to stay in front of it

The mechanism of injury can provide useful clues to finding shock in pediatric patients before it is too late. If the patient lost any blood, possibly ruptured a hollow organ, or became dehydrated after being locked in a hot car for an hour, shock is possible. And if shock is possible, the medics should be treating the patient for shock. The medics should treat the patient for shock even if the patient looks fine. The medics should treat the patient even if the patient has normal vital signs. The only way to beat pediatric shock is stay in front of it.

In the absence of a mechanism of injury, a history of vomiting, diarrhea, or infections could lead the medics to consider the possibility of septic shock. Sepsis is an infection of the blood that results in system wide vasodilation. Depending upon the severity of the history, the medics might decide to treat for shock to be on the safe side. The only way to beat pediatric shock is to stay in front of it.

Physical findings of pediatric shock include:

• Rapid heart rate
• Rapid respiratory rate
• Weak or absent pulse (decompensated shock)
• Altered mental status
• Pale, cool, clammy skin
• Capillary refill time 3 seconds or greater

Management of shock is the same in pediatrics as it is for adults. High flow oxygen administration, preventing heat loss with a blanket, and elevating the feet (if possible). Address the underlying causes of shock if possible (direct pressure on a bleeding would, etc.).