Episode 50 Recognition and Management of Pediatric Sepsis and Septic Shock

Emergency Medicine Cases

Dr. Anton Helman

Education, Health & Fitness, Courses, Medicine, Science

4.7 • 602 Ratings

🗓️ 26 August 2014

⏱️ 38 minutes

🔗️ Recording | iTunes | RSS

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Summary

Kids aren't little adults. Pediatric sepsis and septic shock usually presents as 'cold shock' where as adult septic shock usually presents as 'warm shock', for example. In this episode, a continuation of our discussion on Fever from with Ottawa PEM experts, Sarah Reid and Gina Neto, we discuss the pearls and pitfalls in the recognition and management of pediatric sepsis and septic shock. We review the subtle clinical findings that will help you pick up septic shock before it's too late as well as key maneuvers and algorithms to stabilize these patients. We cover tips for using IO in children, induction agents of choice, timing of intubation, ionotropes of choice, the indications for steroids in septic shock, and much more.....

Transcript

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0:00.0	Yeah, this is EMCases episode 50 on pediatric sepsis.
0:16.8	Welcome to the Emergency Medicine Cases podcast.
0:20.1	I'm your host, Dr. Anton Hellman, bringing you Canada's
0:23.0	brightest minds in emergency medicine from EMC Studios in Toronto. On this episode, we have two
0:32.0	pediatric emergency physicians from the Children's Hospital of Eastern Ontario, that's Chio.
0:41.9	Dr. Sarah Reed is a clinical investigator at the Chio Research Institute and an assistant professor in the Department of Pediatric and Emergency Medicine at the University of Ottawa.
0:47.4	She's the director of continuing medical education at Chio and is co-lead of the Chio ED Outreach
0:53.1	program, which brings evidence-based pediatric emergency
0:55.9	care and clinical resources to community emergency departments. Dr. Gina Netto is an assistant professor
1:01.6	at the University of Ottawa. She was the Associate Medical Director and Chief of the Division
1:06.4	of Emergency Medicine at Chio, as well as a clinical investigator at the CHOO Research Institute.
1:11.8	She's also the chair of the Royal College of Physicians and Surgeons of Canada Pediatric
1:16.1	Emergency Medicine Specialty Committee.
1:20.1	But even ketamine can cause hypotension in a child that's catecholine depleted.
1:29.3	You want to get in 60 mils per kilo of normal saline
1:34.3	as quickly as you can within that first hour.
1:37.3	So instead of the ABCs, it's the C in these.
1:45.4	As soon as you suspect that this child has fluid refractory shock, you should be preparing
1:50.1	to start your ionotrope.
1:53.0	I would never put it on the pump and plug in 999 and hope for the best.
1:59.6	Hey folks, I'd like to announce a new collaboration that I'm really excited about.
2:03.7	This collaboration is with TREC. That's Translating Emergency Knowledge for Kids. This is an amazing,
	...

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