Introduction: The mortality of severely ill children presenting with life-threatening emergencies remains high in emerging countries. The objective of this study was to evaluate the management of shock in the pediatric emergency department of the CNHU in accordance with WHO guidelines. Methods: The cross-sectional study covered the period from 1 November 2019 to 31 October 2020. All records of children aged 1 month to 18 years, who presented with shock, were analysed after implementation of life-saving measures. Results: The hospital incidence of shock was 2.6%, and its diagnosis was made on admission in 81.2% of cases. The median age of the children was 29.50 months. Septic shock occurred in 50% of cases. Mortality was 50%, related to the presence of fever on admission. The triage and sequence of management was correct. However, the median time to care was 30 minutes, the use of the intraosseous access was non-existent, and traceability should be improved. Conclusion: The introduction of an intraosseous kit is essential in order to reduce management delays. The priority remains the fight against infectious pathologies.