- Airway Support: O2 / BVM / Intubate for profound shock
- Gastric decompression with Salem sump tube and place to low continuous suction, including patients with a G-tube.
- Establish venous access, start desired intravenous fluids (IVF)
- Bolus with 0.9% NS 20 mL/kg for compromised perfusion. Reassess and repeat bolus for indications of cardiovascular compromise.
- Obtain blood cultures and start the following antibiotics
- Vancomycin 15 mg/kg IVPB
- Gentamicin age based (See Pediatric Medication Formulary)
- Metronidazole (Flagyl) 7.5 mg/Kg IVPB over 1 hour
- Maintain normal body temperature
- Obtain serum chemistry. Treat abnormal levels per medical control.
- Obtain abdominal films if possible.