A 4-year-old with fever, petechiae and lethargy has BP 70/38, HR 176, capillary refill 5 seconds, glucose 4.2 mmol/L, and no signs of fluid overload.

Question

A 4-year-old with fever, petechiae and lethargy has BP 70/38, HR 176, capillary refill 5 seconds, glucose 4.2 mmol/L, and no signs of fluid overload. What is the most appropriate next step?

Accepted Answer

Give high-flow oxygen, rapid isotonic fluid boluses with reassessment, early antibiotics and vasoactive support if shock persists

Answer

Give antipyretics before vascular access

Answer

Transfer before antibiotics to avoid masking cultures

Answer

Restrict fluids because petechiae imply meningitis

Answer

Give oral antibiotics and observe in the waiting room

Paediatric septic shock — RCPSC EM MCQ

A 4-year-old with fever, petechiae and lethargy has BP 70/38, HR 176, capillary refill 5 seconds, glucose 4.2 mmol/L, and no signs of fluid overload. What is the most appropriate next step?