Regional Emergency Medical Advisory Committee of New York City
Prehospital Basic Life Support Protocols
Copyright January 1996 (8/96)

458 PEDIATRIC SHOCK

NOTE: SHOCK IN THE CHILD IS CHARACTERIZED BY SIGNS OF INADEQUATE PERIPHERAL (DISTAL) PERFUSION, WHICH MAY INCLUDE ALTERED MENTAL STATUS; TACHYCARDIA; PALLOR; COOL, CYANOTIC LOWER EXTREMITIES; MOTTLING; DELAYED CAPILLARY REFILL; WEAK OR ABSENT PERIPHERAL (DISTAL) PULSES.

THE DEFINITION OF SHOCK IN THE CHILD DOES NOT DEPEND UPON BLOOD PRESSURE.

Monitor the airway.

Observe spinal injury precautions, if appropriate. (See Protocol #421.).

Administer oxygen.

NOTE: HIGH CONCENTRATION OXYGEN SHOUD ALWAYS BE USED IN PEDIATRIC PATIENTS.

If patient has an altered mental status, the patient must be ventilated at the rate of at least 25 breaths per minute.

Control external bleeding.

Request Advanced Life Support assistance.

Transport, keeping the child warm.

Apply MAST and inflate, if appropriate.

Do NOT delay transport.

NOTE: DO NOT INFLATE THE ABDOMINAL COMPARTMENT IN PATIENTS UNDER 9 YEARS OF AGE.

Elevate the legs.

Treat all injuries as appropriate.

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