Septic shock

Paediatric emergency management · Circulation · Emergency

Recognise early: fever/hypothermia, tachycardia, altered perfusion or mental state. Within the first hour: oxygen, access, cultures, broad-spectrum antibiotics.

Resuscitation bundle

• Isotonic fluid 10–20 mL/kg boluses, reassessing for fluid overload after each (10 mL/kg where cardiac dysfunction likely).
• Empirical antibiotics within the first hour – do not delay for cultures.
• Measure lactate and glucose; correct hypoglycaemia and hypocalcaemia.

Fluid-refractory shock

• Start adrenaline or noradrenaline (peripheral dilute or central) – do not wait for a central line.
• Consider stress-dose hydrocortisone if catecholamine-resistant / suspected adrenal insufficiency.