For the medics

Medic Protip of the day: Sepsis in an infant causes intravascular volume depletion via increased capillary permeability and vasodilation. This is a form of distributive shock. The therapy of choice for pediatric patients with sepsis (as evidenced by tachycardia and increased capillary refill time in a febrile patient) is bolus doses of isotonic crystalloid or colloid fluids. This should be done until perfusion improves, or new onset rales develops. Dose is 10-20 ml/kg, titrated to heart rate, capillary refill, urinary output, and changes in level of consciousness.