Patient Care Policy (Pediatric)

Modified On: April 10, 2012

SHOCK AND HYPOTENSION

Pediatric Routine Medical Care NOTE: Shock in children may be subtle and hard to recognize. Determining BP may be difficult and readings may be inaccurate IMPORTANT SIGNS OF SHOCK: Cool, clammy, mottled skin Pallor - due to decreased skin perfusion Altered level of consciousness - due to decreased perfusion to the brain BP < 70 systolic Initiate early transport and treat en route, if appropriate Go to Trauma Patient Care (page 23) if trauma suspected Go to Allergic Reaction (page 57) if anaphylaxis suspected Use an LBRT to determine pediatric drug doses (Shown underlined on the algorithm)

Cardiogenic Shock

Hypovolemic Shock Septic Shock Spinal Shock

Contact base physician

Control Hemorrhage, if appropriate NS IV/ IO - 20 ml/kg Fluid Bolus

Base physician consult Yes

Continuing signs of shock?

No

Repeat Fluid Bolus

SHOCK AND HYPOTENSION

Reassess as needed
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