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Paediatric sepsis — DipIMC MCQ

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HardPaediatric and Obstetric EmergenciesPaediatric sepsisDipIMC

A 2-year-old is floppy with fever, mottled skin and capillary refill 5 seconds. Respiratory rate is 48 and oxygen saturations are 91%. What is the most appropriate immediate action?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: CGive oxygen, support circulation and pre-alert for sepsis

Explanation lettering: D = shown as A · C = shown as B · A = shown as C · B = shown as D

A is correct: Paediatric sepsis with shock signs requires immediate oxygen, circulatory support and rapid transfer. B is less suitable because it does not address the discriminator in the vignette; C is less suitable because it moves the patient before the decisive threat or destination issue is addressed; D is less suitable because it moves the patient before the decisive threat or destination issue is addressed; E is less suitable because it creates avoidable delay in a time-critical presentation. The most tempting alternative is therefore suboptimal because it either delays the time-critical pre-hospital intervention or sends the patient to the wrong level of care. The key DipIMC principle is focused cABCDE decision-making with early pre-alert, triage or retrieval escalation when the scene physiology demands it.

Reference: JRCALC Guidelines; Resuscitation Council UK Paediatric and Newborn Guidelines; NICE NG39