The primary goals for managing shock are to increase oxygen delivery to the tissues, balance tissue perfusion and metabolic demand, reverse perfusion abnormalities, maintain organ function, and prevent the deterioration to cardiac arrest. Early intervention significantly increases the outcome and survival of pediatric patients in shock. 

This section will focus on the steps of initial shock management, interventions for advanced management, and specific management according to the cause of shock. Further discussion will involve the fundamentals and principles of the recommended interventions.

The provider must observe for clinical signs of deterioration from shock, including:

• Increasing heart rate
• Diminishing peripheral pulses and central pulses
• Narrowing pulse pressure
• Prolonged capillary refill
• Cold extremities
• Altered sensorium
• Hypotension (a late finding)

Provider takes a child’s blood pressure.