Shock Management Flashcards

A child with known congenital heart disease develops cardiogenic shock. Which vasoactive agent is most appropriate to improve cardiac contractility?

Answer: Dobutamine

Dobutamine is a beta-1 agonist that increases myocardial contractility and is first-line for cardiogenic shock with preserved blood pressure.

A 4-year-old with purpuric rash, fever, and hypotension most likely has which type of shock?

Answer: Septic (distributive) shock

Purpuric rash with fever and hemodynamic instability suggests meningococcemia causing septic shock, a form of distributive shock.

Which hemodynamic pattern is characteristic of hypovolemic shock?

Answer: Low CO, high SVR

Hypovolemic shock causes reduced preload, leading to low cardiac output and compensatory increased systemic vascular resistance.

A child in septic shock with fluid-refractory hypotension and suspected adrenal insufficiency should receive which additional treatment?

Answer: Hydrocortisone stress dosing

Hydrocortisone is indicated for catecholamine-resistant septic shock when adrenal insufficiency is suspected to restore vascular responsiveness.

What is the target mean arterial pressure (MAP) goal when managing pediatric septic shock?

Answer: Age-appropriate normal MAP

MAP goals in pediatric septic shock should be age-appropriate, as normal MAP varies significantly from infants to adolescents.

Which of the following best describes 'cold shock' in a septic pediatric patient?

Answer: Hypotension with cool extremities, prolonged CRT, and weak pulses

Cold septic shock is characterized by low cardiac output with compensatory vasoconstriction, producing cool extremities and weak pulses.

A 10-year-old trauma victim has HR 130, BP 80/50, and estimated 30% blood loss. What is the best initial vascular access strategy?

Answer: Establish intraosseous access immediately if peripheral IV fails

Intraosseous access provides rapid, reliable vascular access when peripheral IV cannot be established quickly in a critically ill child.