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Initial assessment and stabilization of children with respiratory or circulatory compromise

Susan Fuchs, MD
Section Editor
Susan B Torrey, MD
Deputy Editor
James F Wiley, II, MD, MPH


The initial evaluation of critically ill children must quickly identify those with respiratory or circulatory compromise. Early recognition and treatment of a patient with deficiencies in oxygenation, ventilation, or perfusion frequently prevents deterioration to respiratory or cardiac arrest. Outcomes for children who develop cardiopulmonary arrest are poor [1,2].

This topic will review the clinical features that rapidly identify children with respiratory failure or circulatory compromise. Priorities for initial stabilization are presented.

Airway management techniques, including rapid sequence intubation (RSI), are discussed separately. (See "Basic airway management in children" and "Emergency endotracheal intubation in children" and "Rapid sequence intubation (RSI) outside the operating room in children: Approach".)

More detailed discussions of assessment of circulation and the definition and treatment of shock are also discussed in detail elsewhere. (See "Assessment of perfusion in pediatric resuscitation" and "Pathophysiology and classification of shock in children".)


Most children with respiratory or cardiovascular compromise can be easily recognized during a rapid initial assessment. Obvious examples include children with respiratory conditions such as severe asthma exacerbations, or inadequate perfusion, such as hypovolemic shock. (See "Assessment of perfusion in pediatric resuscitation".)

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Literature review current through: Oct 2017. | This topic last updated: Nov 06, 2017.
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