When Ebola virus disease is complicated by shock — signalled by critically low blood pressure or other markers of inadequate tissue perfusion — immediate, structured intervention is required. The clinical definitions and priorities differ between adults and children.

Adults: systolic blood pressure < 90 mm Hg, or other clinical signs of hypoperfusion.

Children: delayed capillary refill > 3 seconds, cold extremities, weak rapid pulse, or hypotension for age.

Immediate priorities include restoring oxygenation and establishing vascular access for isotonic fluid resuscitation. Early empiric antimicrobial coverage is also part of the initial response. The complete protocol — specific agents, volumes, reassessment intervals, and decision thresholds — is available in full via the link below.

References

Shock in adult: SBP < 90 mm HG, mean arterial blood pressure < 65 mm Hg or other clinical signs of hypoperfusion.
Shock in child: delayed capillary refill > 3 seconds, cold extremities, weak rapid pulse or hypotension for age (SBP < 70 + (age in years x 2)).
Give oxygen therapy immediately to maintain SpO2 > 94%
Use isotonic crystalloid fluid for fluid resuscitation; 0.9% saline or Ringer's lactate (RL) solution.
In adults, bolus with 500 ml up to 30 ml/kg or until normalization of signs of perfusion.
In well-nourished children bolus 10–20 ml/kg as initial bolus over 30–60 minutes (use lower dose for malnourished children).
Give empiric antimicrobials (within 1st hour).
SBP > 90–100 mm Hg for adult, or age-appropriate for child
Urine output > 0.5 mL/kg/hr for adult; > 1 mL/kg/hr for child
Re-assess vital signs every 30 minutes for fluid responsiveness, markers of perfusion and fluid losses

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Ebola Virus Disease in Shock: Systolic Blood Pressure < 90 mm Hg or Signs of Hypoperfusion