Perspectives on aetiology, pathophysiology and management of shock in African children

Publication date: Available online 21 November 2017 Source:African Journal of Emergency Medicine Author(s): Julius Nteziyaremye, George Paasi, Kathy Burgoine, Jaffer Sadiq Balyejjusa, Crispus Tegu, Peter Olupot-Olupot Paediatric shock is still a common emergency of public health importance with an estimated 400,000–500,000 reported cases annually. Mortality due to paediatric shock has varied over the years. Data in 1980s show that mortality rates due to septic shock in children were over 50%; but by the end of the year 2000 data indicated that though a marked decline in mortality rates had been achieved, it had stagnated at about 20%. Descriptions of paediatric shock reveal the lack of a common definition and there are important gaps in evidence-based management in different settings. In well-resourced healthcare systems with well-functioning intensive care facilities, the widespread implementation of shock management guidelines based on the Paediatric Advanced Life Support and European Paediatric Advanced Life Support courses have reduced mortality. In resource limited settings with diverse infectious causative agents, the Emergency Triage Assessment and Treatment (ETAT) approach is more pragmatic, but its impact remains circumscribed to centres where ETAT has been implemented and sustained. Advocacy for common management pathways irrespective of underlying cause have been suggested. However, in sub Saharan Africa, the diversity of underlying causative organisms an...
Source: African Journal of Emergency Medicine - Category: Emergency Medicine Source Type: research