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Pediatric CCRN Updated 2024/2025 Verified 100%
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Septic Shock Management Step Three - -Antibiotics (first 60 min) -Broad Spectrum antibiotics -Try to obtain culture first -Consider IM administration if hard to get IV access - Start with Gram Negative spectrum before Gram Positive Septic Shock Management Step One - - Recognition and Access: ...

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  • September 8, 2024
  • 5
  • 2024/2025
  • Exam (elaborations)
  • Questions & answers

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  • pediatric ccrn

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  • Pediatric CCRN
  • Pediatric CCRN

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Pediatric CCRN
Septic Shock Management Step Three - -Antibiotics (first 60 min)

-Broad Spectrum antibiotics

-Try to obtain culture first

-Consider IM administration if

hard to get IV access

- Start with Gram Negative spectrum before Gram Positive



Septic Shock Management Step One - - Recognition and Access: Diminished LOC, begin HFNC, if
hypoxic intubate

- Start IV access: peripheral or central



What does SIRS stand for? - Systemic Inflammatory Response Syndrome



Key characteristics of Endotheliopathy - • Capillary leak

• Vasomotor paralysis tone of vessels not normal

• Leukocyte infiltrations

• Coagulopathy

• Myocardial depression

• Immune-compromise



Patient Qualifications of SIRS based off clinical findings. - Two Abnormalities

-Must be abnormalities of temperature (greater than 38 rectal or less than 36 rectal) or WBC in children

-Other abnormalities include:

1. HR (Tachycardia)

2. RR (Tachypnea)

3. PaCo2 Less than 32

4. Abnormal WBC>12,000 or less than 4,000

, 5. WBC bands greater than 10% differential



Management of SIRS - 1. Treat underlying Cause

2.Manage coagulopathies: thrombocytopenia← replace platelet, clot formation← give thrombolytic,
bleeding

3. Mange the endothelipathies: stop inciting insult, fluid resuscitate, increase plasma oncotic pressure
(colloid administration)

4. Promote Vasoconstriction: Alpha Agonist



Septic Shock - - Sepsis plus CV dysfunction: Abnormal perfusion as well as hypotension.

- Children able to maintain BP longer than Adults




Septic Shock Management Step Two - - Fluid Resuscitation

- Rapid administration 20mL/Kg bolus of isotonic crystalloid

-Run over 5-10 minutes

• 0.9% NaCL (normal saline)

• Lactated ringers




Septic Shock Management Step Four - 4. Inotropic Agent support



WARM SHOCK - 1. High cardiac output

2. Low Systemic Vascular Resistance (SVR)



Inotropic Agent for Warm Shock? - 1. Dopamine

2. Nor-epi

*Utilize EPI or Vasopressin if not responsive

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