Overview
There are multiple clinical signs that suggest hypoperfusion, or shock.
Signs of Hypoperfusion
- Tachycardia
- Tachypnoea
- Hypotension
- Cool peripheries
- Clamminess
- Altered mental status
- Reduced urine output (<0.5mL/kg/hr)
Pearls: Hypoperfusion
- If shock is suspected, escalate immediately.
- Patients with distributive shock (sepsis, anaphylaxis) are generally significantly vasodilated and will not be peripherally cool.
Prolonged Capillary Refill Time
How to Perform
- Apply pressure to the nail bed until it blanches, release and measure the time taken for colour to return.
If the time is more then 2 seconds, then this suggests hypoperfusion.
Causes of Prolonged Capillary Refill Time
- Shock
- Dehydration
- Reduced peripheral perfusion
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