PALS hospital-based shock scenario


The quiz
You are caring for a 12-year-old patient who has a history of leukemia. He was admitted to your floor last night from the emergency department. On admission, he had a fever of 102.2 F and had been feeling bad for two days. His last chemotherapy was one week ago. Mom calls you into the room because “he isn’t acting right.” You arrive to find a 12-year-old (41kg) male who is lethargic and confused. His heart rate is 148 with a blood pressure of 80/30. Respirations are 38 and unlabored. Sp02 is 93% on room air. You immediately notify the emergency response team.


about 3–5 minutes

Question 1 of 4

Your first intervention for this child should be:

Question 2 of 4

The IV team was unable to establish IV access earlier in the day, so this patient does not currently have vascular access available. You should prepare to achieve access via

Question 3 of 4

Vascular access has been obtained. What should be administered now?

Question 4 of 4

This patient is most likely suffering from:

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The quiz

Correct answers

  • Apply oxygen 100% via non-rebreather
  • Intraosseous.
  • Normal saline solution 20ml/kg bolus
  • Distributive shock (sepsis)

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