Recommendations for the initial management of septic shock in children.

We present an update on recommendations for managing septic shock in the emergency department during the "golden hour," highlighting the importance of early recognition and rapid implementation of therapeutic measures to reduce morbidity and mortality. It includes specific diagnostic criteria (the Phoenix Sepsis Scale), which improve the identification of sepsis and septic shock, although their usefulness in the initial stage is limited. This update covers strategies for hemodynamic support, airway management, individualized ultrasound-guided fluid therapy, and the safe use of vasoactive drugs administered via peripheral routes. It emphasizes the importance of administering antibiotics within the first hour. Incorporating these elements into institutional protocols helps optimize initial treatment in the emergency department, even in settings with limited resources. It serves as a key tool for improving the prognosis in pediatric patients with sepsis.