Why is the evaluation of abdominal pain challenging in a child? The diagnosis of abdominal pain can often be determined by a good history and physical examination, but these can be difficult to obtain from infants and young children. In addition, infants with abdominal pain may present with nonspecific signs, such as irritability, poor feeding, …
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How is anaphylactic shock treated? Most manifestations of anaphylaxis, including hypotension, respond well to intramuscular epinephrine. Epinephrine has both α- and β-receptor agonist effects, so it can effectively treat bronchospasm and hypotension. Sources American Heart Association: 2010 Guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Part 12.2: Cardiac arrest associated with anaphylaxis. circulation 2010;122:S829-S861.
What is early goal directed therapy? Early, goal-directed therapy is a management scheme that has been most strongly promoted for children with septic shock. This therapy is an aggressive approach to improve physiologic indicators of perfusion and vital organ function in the first 6 hours. Physiologic indicators targeted during early, goal-directed therapy include the following: …
How to select initial pressor agents for patients in septic shock? For patients with evidence of shock refractory to adequate fluid resuscitation, dopamine is started initially if the patient is normotensive. For patients who are hypotensive, norepinephrine is the agent of choice when systemic vascular resistance (SVR) is low (warm shock), and epinephrine (< 0.3 …
How to choose an appropriate antibiotic for the septic shock? Septic shock is a severe and life-threatening condition and should be treated promptly. It may, however, be impossible to identify the causative organism in a timely fashion. Therefore, empirically administer antibiotic therapy. In most cases, it is prudent to choose broad-spectrum agents that are effective …
How is septic shock treated? Treatment of septic shock is difficult and complex. Early recognition and aggressive resuscitation are critical to improving outcomes. Fluid therapy is usually employed first, but pressor agents are often required. Treatment with antibodies directed against the inflammatory mediators has not proved to be effective, but as our understanding of this …
What is the treatment for neurogenic shock? In neurogenic shock, injury to the spinal cord results in decreased sympathetic input to the vascular system. Most of the patient’s blood supply is left in the venous or capacitance system. Fluid therapy is an appropriate initial treatment, but pressor agents may also be needed. Norepinephrine and phenylephrine are powerful α-agonists and …