Pediatric Assessment Triangle (PAT) Suspect Cardiogenic Shock “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 pO2 <100 Definite CHD pO2 100-250 May have CHD pO2 > 250 No 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