4 Pediatric Shock Free Online FlashCards

What defines shock?

Shock is inadequate tissue perfusion: the body’s tissues are not receiving enough oxygen and nutrients.

Does normal blood pressure rule out pediatric shock?

No. Children can maintain blood pressure through compensatory increases in heart rate and vascular tone, so hypotension is often a late sign.

What findings can suggest compensated shock?

Compensated shock may cause fast heart rate and breathing, weak peripheral pulses, cool or pale skin, delayed refill, behavior changes, and reduced urine output.

What findings suggest decompensated shock?

Low blood pressure, absent peripheral or weak central pulses, cold mottled skin, lethargy or reduced consciousness, and very little or no urine can indicate decompensation.

How can early distributive shock differ in skin and pulses?

Early distributive shock, including septic shock, may cause warm skin, bounding pulses, and brisk capillary refill rather than cool skin and delayed refill.

What capillary refill time can indicate impaired perfusion?

Color returning after more than about 2 seconds can indicate impaired perfusion. Interpret refill alongside temperature, lighting, and other findings.

What systolic blood pressure thresholds screen for pediatric hypotension?

The screening thresholds are below 70 mm Hg for infants; below $70 + 2 \times \text{age in years}$ mm Hg for ages 1–10; and below 90 mm Hg for children older than 10. These identify hypotension, not early shock.

What should a perfusion assessment include?

Use an age-appropriate ABCDE assessment and trend mental status, pulses, skin, capillary refill, breathing, oxygenation, and urine output; interpret the whole clinical picture.

What access should be obtained promptly in a critically ill child with shock?

Obtain IV access promptly; use intraosseous access if needed in a critically ill child.

When is oxygen indicated during initial stabilization?

Give oxygen for hypoxemia or significant respiratory compromise, while supporting airway and breathing.

How should fluid boluses be given for septic shock?

For septic shock, isotonic crystalloid may be given in $10\text{–}20\ \mathrm{mL/kg}$ aliquots. Reassess perfusion and fluid overload after every bolus; stop if shock resolves or overload appears.

What is a key early response to traumatic hemorrhagic shock?

Control external bleeding and activate the trauma or blood-product pathway early. For hypotensive traumatic hemorrhagic shock, blood products are preferred over continued crystalloid when available.