Multisystem Inflammatory Syndrome (MIS-C) Clinical Pathway — Emergency, ICU and Inpatient
Common Features of Shock in Children
It can be difficult to recognize children with compensated shock, as these children will have normal blood pressures. Other important clinical findings that may suggest shock are:
- Altered mental status
- Tachypnea
- Tachycardia out of proportion to fever, or present despite the fever going away
- Diminished urine output
- Cool extremities with weak pulses and prolonged capillary refill (≥ 3 seconds) OR warm extremities with bounding pulses and flash capillary refill (< 1 second)
- Children with cardiogenic shock and/or myocardial dysfunction may have hepatomegaly or crackles; it is important to assess for these signs initially and monitor for them as patients receive fluid resuscitation
- Acidosis (including low serum bicarbonate, base deficit on blood gas testing)
- Elevated lactate