Peds

Pediatric septic shock airway

Before / During / After / Pitfalls

Before

• Shock resuscitation, antibiotics, access/IO, fluids/blood/vasopressors per pediatric sepsis pathway before paralysis when feasible.
• Use length-based weight for meds and equipment.
• Plan induction and PPV transition around hypotension risk.

During

• Assign BP/pressor watcher; minimize apnea and excessive intrathoracic pressure.
• Confirm tube and immediately reassess perfusion, EtCO₂, glucose, temperature, and BP.
• Use peds-appropriate ventilator settings.

After

• Continue shock bundle, source control, and ICU transfer.
• Analgesia/sedation without hemodynamic collapse.
• Reassess lactate/perfusion and ventilator interaction with preload.

Pitfalls

• Airway before resuscitation when not forced.
• Adult dosing/equipment assumptions.
• Over-sedation after tube.