THE MISFITS Suspect Cardiogenic Shock eg Cyanosis Hepatomegaly Cardiomegaly Murmur Pulse Differential Respiratory Distress Tachycardia Hyperoxia Test ABCs IV O2 Monitor Improved ID: 344024
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Pediatric Assessment Triangle (PAT)
“THE MISFITS”
Suspect Cardiogenic Shock
e.g., Cyanosis, Hepatomegaly, Cardiomegaly, Murmur, Pulse Differential, Respiratory Distress, Tachycardia
Hyperoxia Test
ABCs, IV, O2, Monitor
Improved
Not Improved or Worse
pO
2
<100
Definite CHD
pO
2 100-250May have CHD
pO2 > 250No CHD
Probable Sepsis
Continue Fluid Resuscitation and Antibiotics
Start Vasopressors
Intubate
PGE-1 @ 0.05 to 0.1 mcg/kg/min if less than 4 weeks old
CXR
Focal Infiltrate
Cardiomegaly, Pulmonary edema, Hepatomegaly
CHF
Pneumonia, Aspiration
Antibiotics, Supportive Care
Furosemide, Digoxin, Cardiology
Cardiology for Stat Echo and/or Transfer
Shock
No Shock
Resuscitate NS 10 mL/kg
Respiratory Distress or Failure
Cyanosis
No Cyanosis