Pediatric Septic Shock

<p>Announcements: </p><p>1) The interactive <a href="https://clinicalpathways.ebmedicine.net/" style="color:#0000FF;">Clinical Pathways</a> have launched and they are available for free! </p><p>2) 2023 E/M coding guidelines are in effect. See the summary <a href="https://foamed.ebmedicine.net/rapid-reference/2023-e-m-coding-guidelines/" style="color:#0000FF;">here</a>. </p><p>___</p><p> </p><p>In this episode, Sam Ashoo, MD, interviews Ara Festekjian, MD, one of the authors of the November 2022 Pediatric Emergency Medicine Practice article on <a href="https://www.ebmedicine.net/topics/infectious-disease/pediatric-emergency-medicine-septic-shock" style="color:#0000FF;">Pediatric Septic Shock in the Emergency Department</a></p><p> </p><p>Introduction: How common is sepsis in kids and what is the mortality rate in the US?</p><p> </p><p>Definitions</p><ul><li>Septic shock</li><li>Sepsis associated organ dysfunction</li><li>Sepsis-3</li><li>Compensated vs uncompensated shock</li></ul><p> </p><p>Etiology</p><ul><li>Neonate</li><li>Central line and VP shunts</li><li>Asplenia</li><li>Immunocompromised children</li></ul><p> </p><p>Differential Diagnosis</p><p> </p><p>Prehospital Care</p><p> </p><p>ED Evaluation</p><ul><li>History</li><li>Examination</li><li>Septic shock + cardiogenic shock</li><li>Warm vs cold shock</li><li>Evolution of physical exam findings</li></ul><p></p><p>Diagnostics</p><ul><li>Labs</li><li>Imaging</li></ul><p></p><p>Treatment</p><ul><li>IV/IO placement</li><li>Fluid boluses</li><li>Antibiotics </li><li>Pressors </li><li>Airway management </li></ul><p></p><p>Special Populations</p><ul><li>Febrile neutropenia</li><li>Newborns with septic shock</li></ul><p></p><p>Controversies</p><ul><li>Fluid volume</li><li>Fluid type</li><li>Antibiotic timing</li><li>Corticosteroids</li></ul>