How to Recognize Signs of Paediatric Shock

As a healthcare provider, one of the first things to look for in a poorly child is signs of paediatric shock. Paediatric shock is a life-threatening condition in children that occurs when the body's circulatory system fails to deliver enough blood to the organs. This can lead to several serious health problems, including organ failure and death.

Children are at an increased risk of developing shock, as their bodies have less physiological reserves than adults. This means they may not show any obvious signs of shock even after severe fluid depletion. When symptoms do occur, they can progress rapidly.

There are four main types of shock in children:

1. Hypovolemic shock 
2. Obstructive shock 
3. Cardiogenic shock 
4. Distributive shock

The symptoms of shock in children can vary depending on the type of shock and the severity of the condition. As a healthcare provider, some common signs to look for in a paediatric patient include:

• Rapid breathing
• Rapid heart rate
• Cool, clammy skin
• Pale or greyish skin colour
• Low blood pressure
• Confusion
• Loss of consciousness

Here is a summary of the four different types of shock and their causes in children:

1. Hypovolemic shock is caused by a loss of blood or fluids, which can decrease the circulating blood volume. Trauma, burns, dehydration, or other conditions can cause this.

2. Obstructive shock is caused by an obstruction that prevents blood from flowing freely to the heart or other organs. A heart attack, blood clot, or other conditions can cause this.

3. Cardiogenic shock is caused by a failure of the heart to pump blood effectively. A heart attack, congenital heart defects, or other conditions can cause this.

4. Distributive shock is caused by a maldistribution of blood volume, which can decrease blood flow to the heart and other organs. This can be caused by sepsis, anaphylaxis, or other conditions.

Sepsis is the most common cause of shock in children. It is a life-threatening condition that occurs when the body's immune system overreacts to an infection. Sepsis can cause widespread inflammation and organ damage, leading to paediatric shock if not treated promptly.

Practitioner Development UK (PDUK) is a leading provider of continuing professional development (CPD) courses for healthcare professionals. We offer a wide range of courses, delivered both virtually and in-house.

We highly recommend the following course related to paediatric assessment in primary care settings:

P62 The deteriorating child

This course is ideal for clinicians assessing and managing paediatric patients in emergency, urgent, acute and primary care settings.

The course will teach you about paediatric patients' anatomy, physiology and pathophysiology and how to identify and manage patients at risk of decompensation.

You will learn how to:

• Describe the anatomical and physiological differences between paediatric and older patients
• Recognize the unique pathophysiology underpinning paediatric compensatory mechanisms
• Describe how, when those compensatory mechanisms fail, they do so rapidly, catastrophically and irreversibly
• Describe and differentiate between the factors and pathways which make paediatric patients at high risk for decompensation.
• Undertake a safe assessment of a paediatric patient incorporating red flag recognition.
• Apply the NICE guidelines' traffic light system.
• Outline the unique considerations when assessing paediatric patients, including history taking, secondary assessment and reassessment.
• Identify key factors in pregnancy, delivery, childbirth and neonatal history that may impact paediatric risk.
• Evaluate and select appropriate care pathways for paediatric patients.