Pediatric Septic Shock: Recognition and Management in the Emergency Department

Show Notes

Introduction: How common is sepsis in kids and what is the mortality rate in the US?

Definitions

• Septic shock
• Sepsis associated organ dysfunction
• Sepsis-3
• Compensated vs uncompensated shock

Etiology

• Neonate
• Central line and VP shunts
• Asplenia
• Immunocompromised children

Differential Diagnosis

Prehospital Care

ED Evaluation

• History
• Examination
• Septic shock + cardiogenic shock
• Warm vs cold shock
• Evolution of physical exam findings

Diagnostics

• Labs
• Imaging

Treatment

• IV/IO placement
• Fluid boluses
• Antibiotics 
• Pressors 
• Airway management 

Special Populations

• Febrile neutropenia
• Newborns with septic shock

Controversies

• Fluid volume
• Fluid type
• Antibiotic timing
• Corticosteroids