Pediatric Septic Shock

Announcements: 1) The interactive Clinical Pathways (https://clinicalpathways.ebmedicine.net/) have launched and they are available for free! 2) 2023 E/M coding guidelines are in effect. See the summary here (https://foamed.ebmedicine.net/rapid-reference/2023-e-m-coding-guidelines/). ___ 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 (https://www.ebmedicine.net/topics/infectious-disease/pediatric-emergency-medicine-septic-shock) 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 findingsDiagnostics* Labs* ImagingTreatment* IV/IO placement* Fluid boluses* Antibiotics * Pressors * Airway management Special Populations* Febrile neutropenia* Newborns with septic shockControversies* Fluid volume* Fluid type* Antibiotic timing* Corticosteroids