A child in a state of shock in emercency department: classification, mechanisms and treatment
Keywords:children, chest age, shok, mechanisms of development, treatment, sepsis, emergency department
Paediatric shock is a life-threatening condition that can often be difficult to recognize in the emergency department, especially in early stages. Once recognized, the emphasis of therapy is to correct cellular metabolism and gas exchange by increasing oxygen and other substrate delivery to tissue beds. This review discusses various mechanisms and aetiology of shock are discussed, among them hypoxia in infancy, hypovolaemia, impaired distribution, obstruction of the cardiac outflow and sepsis.In septic shock providing oxygen, improving tissue perfusion through restoration in the intravascular volume, augmentation of cardiac output, preservation of kidney function, and administering antibiotics in a timely manner have all been shown to significantly improve outcomes in children. Simple algorithms for first aid in emergency room are given, emphasizes the importance of effective surveillance and timely recognition of this disease process, to significantly reduce morbidity and mortality. The review indicates how to identify specific markers of septic shock, lays out the essential components of goal-directed therapy, and ways to avoid the devastating consequences of shock in paediatric patients
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