Hi everyone and welcome back to another episode of E.M. Basic. I'm Zach Hodges, a pediatric

resident here at the Medical College of Georgia. Today we'll be discussing pediatric

sepsis and I'm excited that we are joined by guests from both the pediatric intensive care

and emergency medicine. Do each of you all want to go around and introduce yourself and tell us a

little bit about your educational background? Hello everyone. My name is Smith and Matthew,

and I am a pediatric intensiveist. Hi, everyone. I'm Katie Verdone, and I'm a pediatric ICU fellow here

at the Children's Hospital of Georgia. And I'm Dan McCollum from Emergency Medicine. Let's get started with

a case. Our patient is a nine-month-old infant brought to a community emergency department with a one-day

history of fever and decrease oral intake. Mom noticed worsening irritability, one episode of

vomiting, and later increased worker breathing, and decreased alertness that calls her to come

to the ED. On arrival, the triage nurse recognized the child was ill and brought her

immediately to the resuscitation room.

Smitha, how would you start the evaluation of this infant?

When examining an acutely ill infant, I start with a pediatric assessment triangle.

Remember, this is a quick visual assessment that includes the general appearance, work of breathing, and color.

It gives us a basic understanding of our patients' neurologic, respiratory,

and cardiovascular status. If one or more abnormal findings are present, that suggests the child is critically ill. These patients will require a structured primary and secondary assessment to

address any abnormalities and prevent further decompensation. The primary assessment is the familiar.

Airway, breathing, circulation, disability, and exposure.

The secondary assessment includes a focused history and a complete physical exam.

Okay, so our patient's pediatric assessment triangle is notable for an irritable infant with increased worker breathing.

Her extremities are modeled.

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