In this episode, Sam Ashoo, MD, interviews Ara Festekjian, MD, one of the authors of the November 2022 Pediatric Emergency Medicine Practice article on Pediatric Septic Shock in the Emergency Department
Introduction: How common is sepsis in kids and what is the mortality rate in the US?
Definitions
- Septic shock
- Sepsis associated organ dysfunction
- Sepsis-3
- Compensated vs uncompensated shock
Etiology
- Neonate
- Central line and VP shunts
- Asplenia
- Immunocompromised children
Differential Diagnosis
Prehospital Care
ED Evaluation
- History
- Examination
- Septic shock + cardiogenic shock
- Warm vs cold shock
- Evolution of physical exam findings
Diagnostics
- Labs
- Imaging
Treatment
- IV/IO placement
- Fluid boluses
- Antibiotics
- Pressors
- Airway management
Special Populations
- Febrile neutropenia
- Newborns with septic shock
Controversies
- Fluid volume
- Fluid type
- Antibiotic timing
- Corticosteroids
