A 6 y/o M presented to the Emergency Department with a fever. On arrival, triage vitals were as follows: T 40.2 HR 140 BP 92/65 SpO2 98% RA. Presumed sepsis is diagnosed, and he is started on his hospital’s Pediatric Sepsis protocol. Bloodwork including blood cultures are drawn. A capillary glucose is checked and was within normal limits. He receives Ceftriaxone 100 mg/kg IV. After one hour of resuscitation he has received 60 mL/kg of NS. Vitals are now as follows: T 39.2 HR 135 BP 90/59 SpO2 97% RA. On examination he has delayed cap refill and cool extremities. What is the best next step?

About the Author: Anton Helman

Dr. Anton Helman is an Emergency Physician at North York General in Toronto. He is an Assistant Professor at the University of Toronto, Division of Emergency Medicine and the Education Innovation Lead at the Schwartz-Reisman Emergency Medicine Instititute. He is the founder, editor-in-chief and host of Emergency Medicine Cases.