Hypotension and Shock

Question 1

Pediatric hypotension

Answer 1

<70 +(2x age in years)

Question 2

Pediatric push dose epi dosage

Answer 2

0.1 mL/kg (1 mcg/kg) every 3 – 5 min PRN max 20

Question 3

Adult push dose epi dosage

Answer 3

0.5–2mL (5–20mcg) every3–5minPRN

Question 4

Adult hypovolemic shock fluid resuscitation

Answer 4

1L LR, may require an additional 2-4 liters

Question 5

Pediatric hypovolemic shock fluid resuscitation

Answer 5

20ml/kg, may require an additional 20-60ml/kg.

Question 6

Adult cardiogenic shock fluid resuscitation

Answer 6

250mL LR bolus, may repeat 3 times if no pulmonary edema is present.

Question 7

Pediatric cardiogenic shock fluid resuscitation

Answer 7

5 – 10 mL/kg NS bolus, may repeat PRN if no pulmonary edema is present (maximum is 60mL/kg total)

Question 8

Adult norepinephrine dose

Answer 8

2 – 45 mcg/min or 0.05 – 2mcg/kg/min, not to exceed 45 mcg/min

Question 9

Pediatric norepinephrine dose

Answer 9

0.05 – 2mcg/kg/min (not to exceed 45mcg/min)

Question 10

Dobutamine infusion dose

Answer 10

(obtain from sending facility)
5 – 20 mcg/kg/min titrated to a maximum of 20 mcg/kg/min

Question 11

Septic Shock criteria

Answer 11

The clinical diagnosis of sepsis is made in adults who have a suspected
infection and two or more SIRS criteria.
1. Temperature > 38°C or < 36°C
2. HR>90bpm
3. RR > 20 breaths/min or PaCO2 < 32 mmHg
4. WBC > 12,000 or < 4000 or > 10% bands

Question 12

Adult septic shock fluid resuscitation

Answer 12

30ml/kg LR. Repeat PRN, up to 3-4 liters may be needed.

Question 13

Pediatric septic shock fluid resuscitation

Answer 13

20mL/kg LR bolus. Repeat PRN. More than 100mL/kg may be required

Question 14

Perfusion s/s to watch for.

Answer 14

1.MAP/BP
2.reassess heart rate
3.oxygen saturation
4.respiratory rate (if not intubated)
5.mental status
6.urine output

Question 15

Vasopressors for septic shock

Answer 15

Norepinephrine
epinephrine
Vasopressin
Dopamine