How do you treat a child with hypovolemic shock?

Ultimately, a child with severe hypovolemia or sepsis should receive 60 mL/kg of volume in the first 15 minutes of early goal-directed therapy (EGDT). If more than 2-3 volumes of crystalloid have been infused into a patient at risk for hemorrhage (eg, from trauma), administer blood or packed red blood cells (PRBCs).

What is the most appropriate treatment for hypovolemic shock?

Fluid resuscitation is the mainstay of therapy in patients with severe hypovolemia.

What are the steps for treating hypovolemic shock?


  1. Keep the person comfortable and warm (to avoid hypothermia).
  2. Have the person lie flat with the feet lifted about 12 inches (30 centimeters) to increase circulation. …
  3. Do not give fluids by mouth.
  4. If person is having an allergic reaction, treat the allergic reaction, if you know how.

What is the first treatment for hypovolemic shock?

Treating hypovolemic shock means treating the underlying medical cause. Physicians first will try to stop fluid loss and stabilize blood volume levels before more complications develop. Doctors usually replace lost blood volume with intravenous (IV) fluids called crystalloids.

What is the appropriate amount of fluid to give a child in hypovolemic shock?

In hypovolemic (or hemorrhagic) shock, administer 3 mL of fluid for every 1 mL of estimated blood lost—a 3:1 ratio. If fluid boluses do not improve the signs of hypovolemic, hemorrhagic shock, consider the administration of packed red blood cells without delay.

What IV solution is used for hypovolemic shock?

Isotonic crystalloid solutions are typically given for intravascular repletion during shock and hypovolemia. Colloid solutions are generally not used. Patients with dehydration and adequate circulatory volume typically have a free water deficit, and hypotonic solutions (eg, 5% dextrose in water, 0.45% saline) are used.

What is the proper position for a patient with hypovolemic shock?

Abstract. Simply elevating a patient’s legs may be effective in cardiogenic or neurogenic shock, but in hypovolemic shock, a patient must be properly placed in Trendelenburg’s position. This nurse describes how and why she places patients in this position.

What happens during hypovolemic shock?

Hypovolemic shock occurs as a result of either blood loss or extracellular fluid loss. Hemorrhagic shock is hypovolemic shock from blood loss. Traumatic injury is by far the most common cause of hemorrhagic shock.

How is shock treated for kids?

Seek emergency medical care

  1. Lay the person down and elevate the legs and feet slightly, unless you think this may cause pain or further injury.
  2. Keep the person still and don’t move him or her unless necessary.
  3. Begin CPR if the person shows no signs of life, such as not breathing, coughing or moving.

How do you bolus a child?

Fluid resuscitation

Isotonic fluid boluses (NS) are the initial approach to the child with moderate to severe dehydration. A bolus is 20 ml/kg (maximum 1 liter). This is typically given over 20 minutes in the child with moderate dehydration and as fast as possible in the child with severe dehydration.

What is the appropriate fluid to give a hypotensive child?

Providing additional volume is the primary means of responding to hypovolemic shock. Lactated Ringer’s or a normal saline (an isotonic crystalloid) is the preferred fluid in resuscitating volume in children.

What treatment should be implemented if a child remains hemodynamically unstable despite 2 to 3 boluses?

– Stop fluid bolus if signs of heart failure (increased respiratory distress or development of rales or hepato- megaly). Consider administration of 10 mL/kg of packed red blood cells if signs of shock and hemodynamic instability persist despite 2-3 boluses of isotonic crystalloids.

What would indicate that a pediatric patient needs an IV bolus infusion?

In children with decompensated shock from conditions such as hypovolemia, sepsis, hemorrhage, and anaphylaxis, cardiovascular collapse may be imminent and rapid fluid bolus therapy is essential.

What is the most appropriate method of delivering rapid fluid boluses?

The disconnect-reconnect and push-pull techniques are probably the most common ways of administering fluid boluses in pediatrics. The disconnect-reconnect method often requires two people, one to prepare multiple fluid-filled syringes and the other to administer the fluid to the patient.

Why does hypovolemic shock occur?

The most common cause of hypovolemic shock is blood loss when a major blood vessel bursts or when you’re seriously injured. This is called hemorrhagic shock. You can also get it from heavy bleeding related to pregnancy, from burns, or even from severe vomiting and diarrhea.

What is considered normal urinary output for a pediatric patient?

Normal urine output is age-dependent: Newborn and infant up to 1 year: normal is 2 ml/kg/hour. Toddler: 1.5 ml/kg/hour. Older child: 1 ml/kg/hour during adolescence.

How fast can normal saline be infused?

A 20 mL/kg 0.9% normal saline bolus (maximum 999 mL) will be administered over 1 hour. This will be followed by D5-0.9% normal saline at a maintenance rate (maximum 55 mL/hr).

Can I Nebulize with saline?

Saline Nebuliser Solution is only to be used as a diluent for diluting products for nebulisation and should not be used on its own. It should not be taken orally or administered parenterally.

Why do doctors use saline instead of water?

Doctors use IV saline to replenish lost fluids, flush wounds, deliver medications, and sustain patients through surgery, dialysis, and chemotherapy. Saline IVs have even found a place outside the hospital, as a trendy hangover remedy. “It has high levels of sodium and chloride, levels that are higher than the blood.