EMS Pediatric Hypovolemic Shock

Learner will arrive on-scene to find a 6-year-old female, listless and lying in bed. Learner will perform an initial assessment and identify that the patient is suffering from a respiratory illness with fever and vomiting. She recently passed out when trying to stand up. Current vitals are HR 150, BP 80/50, R 32, SpO2 91% RA. Capillary refill delayed to 4 seconds. Lung sounds with right-sided crackles. Learner will recognize signs of hypovolemic shock and hypoxia. Learners should place NC oxygen and plan for immediate hospital transport for definitive therapy.

Advanced providers (ALS/SL4) should start 20 mL/kg fluid bolus using the available Burette set.

Learning Objectives

– Assesses scene, identifying any potential safety concerns, number of patients, presence of bystanders, and additional resources available

– Conducts primary survey and obtains vital signs with attention to the following:
a. Determines level of consciousness and identifies mental status impairment
b. Identifies any signs of airway obstruction, hypoxia, or any observable breathing difficulties
c. Identifies any profuse bleeding, signs of decreased or absent circulation, or any pulse deficits in extremities

– Performs immediate interventions to address concerns identified during the primary survey

– Determines priority of transport

– Conducts a secondary survey to gather additional pertinent HPI and PMH and conduct a focused physical exam

– Performs any necessary medical interventions to ensure patient stability and safety during transport

– Contacts Medical Direction when indicated

– Provides verbal report summarizing patient encounter