Module 3: Pediatric Shock, including Vascular Access

Slide 1 - Learning ObjectivesSlide 2 - Pediatric Trauma Fatalities - PathophysiologySlide 3 - Cardiovascular VariablesAffecting Systemic PerfusionSlide 4 - ShockSlide 5 - Hemodynamic Response to ShockSlide 6 - Progression of ShockSlide 7 - Heart Rate Response to Shock in ChildrenSlide 8 - Hemodynamic Responses to Shock in ChildrenSlide 9 - Physical Examination - CirculationSlide 10 - Physical Examination - CirculationSlide 11 - Palpation of Pulses in ChildrenSlide 12 - Pediatric Pulse Check SitesSlide 13 - Video RecapSlide 14 - Heart Rates in ChildrenSlide 15 - Categorization of Shock in Pediatric Trauma PatientsSlide 16 - Shock - Clinical ProgressionSlide 17 - Physical Examination - CirculationSlide 18 - Capillary Refill TimeSlide 19 - Capillary Refill TimeSlide 20 - Video RecapSlide 21 - Estimate of Minimum Systolic Blood PressureSlide 22 - Evaluation of End-Organ PerfusionSlide 23 - Causes of Cardiopulmonary Deterioration in Pediatric Trauma VictimsSlide 24 - Causes of Cardiopulmonary Deterioration in Pediatric Trauma VictimsSlide 25 - Causes of Cardiopulmonary Deterioration in Pediatric Trauma VictimsSlide 26 - Causes of Cardiopulmonary Deterioration in Pediatric Trauma VictimsSlide 27 - Intravenous AccessSlide 28 - Preferred IV Access SitesSlide 29 - Intravenous Catheter SizeSlide 30 - Intraosseous (IO) Needle PlacementSlide 31 - IO Needle PlacementSlide 32 - IO Needle SetupSlide 33 - Video of EZ-IO Vascular AccessSlide 34 - IO Access - ComplicationsSlide 35 - Central Venous Access - AnatomySlide 36 - Fluid Resuscitation - ATLS AlgorithmSlide 37 - Choice of Resuscitation FluidSlide 38 - Review: Question 1Slide 39 - Review: Question 2Slide 40 - Review: Question 3Slide 41 - Review: Question 4Slide 42 - Review: Question 5Slide 43 - Acknowledgments of 43

Intravenous Catheter Size

• Shorter, large bore IV catheters will infuse IV fluids at a faster rate than longer, narrow lines
• Pressurizing the fluid bag or syringing the fluids can achieve faster infusions
• Volumetric pumps or 'buretrol' should be used in small infants to avoid accidental overinfusion of fluids

Type of IV	Gauge	Maximal infusion rate (cc/min)
Peripheral	22	35
	20	60
	18	105
Central	20	17
	18	41

Module 3: Pediatric Shock, including Vascular Access

Preferred IV Access Sites

Intraosseous (IO) Needle Placement