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Advanced Study | Pediatrics Part Five

Pediatric Shock: inadequate delivery of O2, and is the body’s response to poor perfusion. A child may lose up to 20% blood volume before a change in appearance. Leading cause of shock in kids is gastroenteritis with dehydration.

  • Palpate peripheral pulse and listen to apical heart rate for clues on hypovolemia
  • Compensated shock: BP normal, compensate longer than adults
  • Decompensated shock: hypotensive and shows signs of inadequate perfusion, often irreversible
  • Signs of shock:
    • Altered level of responsiveness
    • Hyperventilation leading to respiratory failure
    • Tachycardia
    • Normotensive progressing to hypotension
    • Cool, or cold clammy skin
    • Prolonged cap refill
    • Oliguria – lack of urine productionAcidosis

Dehydration: threat the infant and child because they are greater proportion of water than adults (they are 65%), decrease in cardiac output > renal failure > shock > death

  • Fever
  • Viral gastrointestinal disorder
  • Nausea, vomiting, diarrhea

Treatment:

  • Moderate to extreme: IV of normal saline of LR
  • High flow O2

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