❌ Myth: "Start dopamine — it's the go-to first-line vasopressor in pediatric shock"

✅ Reality: 2 RCTs show epinephrine outperforms dopamine. Dopamine is no longer first-line (Canadian Paediatric Society, 2020).

Epinephrine for cold shock. Norepinephrine for warm shock.

When phenotype is unclear, epinephrine is the safer initial choice — it supports cardiac output without excessive vasoconstriction.