Shock Index, Pediatric Age-Adjusted (SIPA)

Patients that present with an elevated SIPA are at higher risk of morbidity and mortality following blunt trauma. Early recognition and treatment in these cases, including a possible decision to transfer to a higher level of care, will improve outcomes in these children.

• General management of pediatric blunt abdominal trauma includes primary and secondary survey and determination of extent, type, and severity of injury.

• A thorough abdominal exam is extremely important as abdominal injuries are often not apparent on exam. The use of imaging may be warranted depending on exam findings.

Remember that there is no value or finding that necessarily defines shock, and children can compensate more readily than adults. Hypotension is often a late finding in children with hypovolemic shock.