🧒 Pediatric Sepsis/Septic Shock Fluid Resuscitation (SSC)
This tool applies the Surviving Sepsis Campaign 2020 pediatric guideline to fluid resuscitation in septic shock, varying the bolus strategy by availability of intensive care and presence of hypotension.
Pediatric Sepsis/Septic Shock Fluid Resuscitation (SSC)
Intensive care available (locally or by transfer)
Hypotension present
Weight (to calculate bolus volume, optional) (kg)
When to use
Use in children with sepsis or septic shock to set the first-hour fluid strategy and the timing of vasoactive drugs and antibiotics.
How it works
With ICU: 10–20 mL/kg boluses, cumulative cap 40–60 mL/kg; no ICU + hypotension: cap 40 mL/kg; no ICU + no hypotension: no bolus, start maintenance fluids. Epinephrine or norepinephrine first-line; antibiotics ≤ 1 h (shock) or ≤ 3 h (no shock).
Key points
- Each bolus is followed by reassessment (heart rate, perfusion, hepatomegaly, rales, work of breathing) and stopped immediately at any sign of fluid overload.
- Where intensive care is unavailable and there is no hypotension, the guideline strongly recommends against bolus fluids, favoring maintenance fluids.
- Epinephrine or norepinephrine — not dopamine — is the first-line vasoactive agent for fluid-refractory shock, titrated to perfusion and blood pressure.
References
Decision support for licensed clinicians only; not a substitute for clinical judgement, diagnosis or local protocols.