Remember to save childrens lives be aggressive with septic shock treatment early!
Do NOT allow long delays at IV attempts before moving to central lines or IOs.
Goal in the first 0 to 15 minutes from presentation:
Recognize decreased perfusion and mental status, maintain airway, and obtain access.
Push 20 ml/kg of Isotonic bolus (up to and over 60 ml/kg) and reassess shock after each.*
Correct Hypoglycemia and hypocalcemia if present.
When community ED physicians successfully achieved shock reversal (defined by return of normal systolic blood pressure and capillary refill time) in the first 75 min from arrival there was an associated 96% survival and a > 9-fold increased odds of survival.Each additional hour of persistent shock was associated with >2-fold increased odds of mortality.
*To push this amount of fluid in an infant or young child it may be easier to use 60 ml syringes for boluses rather than pumps
References
Han Y. Carcillo J. Early reversal of Pediatric-Neonatal Septic Shock by Community Physicians Is associated with improved outcome. PEDIATRICS Vol. 112 No. 4 October 2003: 793-799.
