Clinical Presentation

Signs and symptoms:

• Respiratory distress: tachypnea, nasal flaring, retractions, grunting, gasping
• Hypotension or shock: tachycardia, weak peripheral pulses, delayed capillary refill, cool extremities, altered mental status
• Cardiac arrest: unresponsiveness, apnea or agonal breathing, no pulses
• Bradycardia: slow heart rate, hypotension, poor perfusion, lethargy, cyanosis
• Tachycardia: palpitations, chest pain, dyspnea, irritability, diaphoresis
• Cardiogenic shock: dyspnea, crackles, hepatomegaly, metabolic acidosis

Demographics: All pediatric age groups affected, but incidence higher in infants and younger children

Pitfalls: Difficulty detecting deteriorating status in infants/young children; shock may present with normal blood pressures initially