Hey everyone! Let's discuss yesterday's question

Hey everyone! Let’s discuss yesterday’s question. The answer is C that is Norepinephrine as correctly mentioned by the intelligent audience i am having here.:slightly_smiling_face:

According to PALS guidelines, irrespective of the shock etiology we start the management with fluid resuscitation in the form of saline boluses, upto 60 ml/kg. If there’s no improvement we label the shock as fluid refractory and start the patient on inotropes.

Now the choice of management of inotrope depends upon whether the shock is warm or cold. If it is warm,the drug of choice is Norepinephrine, if it is cold then the drug of choice is epinephrine. Consider Dopamine if the blood pressure is normal with poor perfusion at this stage.

Further evaluation depends upon scvo2 which would direct further therapy.(Beyond neets scope,so skipping that).

I hope this was helpful.

Best wishes!

Dr Manoj Malhotra
MBBS (MAMC) MD pediatrics (LHMC)