View source for Prehospital protocol pediatric shock

==Perform general assessment==
#100% O2 NRB and Obtain Vital Signs
#If hypotensive, elevate lower extremities IV NS TKO
#Cardiac Monitor / 12 lead ECG / Pulse Oximetry

==Is patient symptomatic with?==
#Chest Pain
#Difficulty Breathing
#Seizure
#Altered Mental Status
#Bradycardia
Follow individual associated protocols

==Assess for signs of hypotension and poor perfusion==
*Weak Pulses
*Capillary refill 3 seconds
*Mottled or cool skin
*Altered mental status
*Hypoxia

==Other signs of shock==
Tachycardia, fever AND one of the following
*Cancer
*Sickle Cell
*Transplant
*Indwelling catheter
*Immune deficiency
*Severe developmental delay

===Pulmonary edema?===

====Yes====
*Give (weight *10)mL NS bolus.
*Reassess for pulmonary edema after each bolus
*Repeat up to 3 boluses 

====No====
*Give (weight *20)mL NS bolus.
*Reassess for pulmonary edema after each bolus
*Repeat up to 3 boluses 

===Advanced Notification===
If treating for shock then ensure advanced notification to receiving hospital.

===Continued hypotension or signs of shock?===
====Yes====
*Begin dopamine drip with titration to age appropriate SBP
*Further orders per on-line physician
====No====
*Reassess en-route