Pediatric emergency medicine trisk 0286 0286

Parameter

Comment

Heart rate

Tachycardia can be a sign of
Age related (
hypovolemia or ongoing shock;
Table 10.7 )
bradycardia can be a sign of shock in
infants or neurogenic shock in older
children
Tachypnea indicates pulmonary disease Age related (
or reflects an increasing metabolic
Table 10.7 )
acidosis
Hypotension may not be evident early Age related (
in compensated shock, especially in
Table 10.7 )
infants/young children. A wide pulse
pressure (DBP <½ SBP) indicates
low SVR (distributive or neurogenic
shock)
Age related (
Table 10.7 )
Age related (
Table 10.7 )
Flash capillary refill can be seen in
1–2 sec
warm shock; delayed capillary refill

can be seen in cold shock
Warm extremities can be seen in warm Normal extremity
shock; cool extremities can be seen
temperature
in cold shock
Lethargy, confusion, agitation, or
Alert and
stupor can be signs of poor endappropriate for
organ perfusion
age
Inadequate urine output is one sign of <30 kg: >1
poor end-organ perfusion
mL/kg/hr
≥30 kg: ≥30
mL/hr
Elevated lactate >2–4 mmol/L may be <2–4 mmol/L or
sign of shock with inadequate
≥10% decrease
oxygen delivery
every 1–2 hrs

Respiratory rate

Systolic blood
pressure

Mean arterial
blood pressure
Diastolic blood
pressure

Capillary refill

Extremity
temperature
Mental status

Urine output

Lactate

Target