EMERGENCY APPROACH IN THE MANAGEMENT OF PEDIATRIC PATIENTS IN SEPTIC SHOCK: DIAGNOSIS AND PROTOCOLS

Abstract

Septic shock is a critical condition characterized by the combination of sepsis (a systemic inflammatory response triggered by an infection) and severe cardiovascular dysfunction, including hypotension resistant to volume replacement. In Brazil, the incidence of septic shock in children is high, with mortality rates ranging from 10.8% to 33.5%. Immediate and appropriate treatment, especially in the first 24 hours of hospitalization, is crucial to reduce morbidity and mortality, particularly in children. The primary objective of this literature review is to structure and gather data on septic shock in pediatric emergency rooms, aiming at early diagnosis and rapid and eficiente establishment of a course of action to reduce complications and, mainly, mortality. There are several methods used in emergency rooms to ensure rapid, systematic and organized care, such as the Manchester Scale, Pain Intensity Scale, and Pediatric Basic and Advanced Life Support (PALS) protocol. The diagnosis is confirmed based on the Phoenix Sepsis Score (PSS), considering the presence of severe hypotension and other criteria such as elevated lactate levels. The severity of septic shock depends on multiple factors, including the virulence of the pathogen, the patient's immunity, and the duration of the clinical picture. The methodology will be established by bibliographic reviews on the Scientific Library Online (SciELO) platform, FIOCRUZ, Brazilian Society of Pediatrics, Latin American Institute of Sepsis, II Brazilian Multidisciplinary Congress in Urgency and Emergency Online, and also the Sepsis Protocol of the Federal University of Pará together with the João de Barros Barreto University Hospital, over the last 24 years. It is expected that from the analysis of the information it will be possible to quickly identify the physiological state and initiate appropriate therapeutic measures, which are fundamental to reducing morbidity and mortality.