Mon25October0844PM 2

In paediatric shock:

True / False

Hyperglycaemia is a common finding Correct

A normal capillary refill time is less than one second Correct

There are clear benefits regarding colloid fluid resuscitation Correct

The initial crystalloid bolus is 20 ml/kg Correct

Hypotension is an early sign of hypovolaemia Correct

Explanation

Children's cardiovascular systems initially compensate well in shock.

Hypotension is a late and often sudden sign of decompensation and if not reversed will be rapidly followed by death. A formula for calculating normal systolic blood pressure is 80 + (2 * age in years).

Capillary refill time is a more useful test of perfusion in children than blood pressure measurement. The skin on the sternum or a digit held at the level of the heart should be pressed for 5 seconds. After blanching pressure has been released the time for the colour to return to normal is measured. A normal capillary refill time is less than two seconds.

Hypoglycaemia and shock may coexist as the sick child or infant has poor glucose producing reserves. Urgent blood glucose estimation must always be performed to exclude this common condition.

Fluid resuscitation in paediatric shock is based on crystalloid blouses of 20 ml/kg, which can be repeated up to three times.

There are no clear benefits regarding colloid fluid resuscitation versus crystalloids in the paediatric population

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