Signs/symptoms of underlying pathology
More common in children than in adults
Poor cardiac output due to decreased stroke volume--> tachycardia to compensate
Poor peripheral perfusion, increased SVR (vasoconstriction) to compensate-->
Skin cold to touch
Diminished pulses
Mottled skin
Cap refill >2s
Narrow pulse pressure, eventually hypotension
Signs and symptoms of end organ damage as blood shunted to vital organs
AMS, tachypnea, nausea/vomiting, AKI, lactic acidosis
Skin cold to touch
Diminished pulses
Mottled skin
Cap refill >2s
Narrow pulse pressure, eventually hypotension
Signs and symptoms of end organ damage as blood shunted to vital organs
AMS, tachypnea, nausea/vomiting, AKI, lactic acidosis
AMS, tachypnea, nausea/vomiting, AKI, lactic acidosis
Hyperdynamic state, with vasodilation and low SVR
Results in end organ damage due to shunting of blood away from vital organs to periphery
Findings thus include:
Tachycardia
Wide pulse pressure
Bounding peripheral pulses
Brisk cap refill
Tachycardia
Wide pulse pressure
Bounding peripheral pulses
Brisk cap refill
Shock Index Pediatric-Adjusted (SIPA)- see https://www.mdcalc.com/shock-index-pediatric-age-adjusted-sipa
Useful in identifying shock in trauma patients
Undifferentiated shock 
Hypovolemia
Neurogenic shock
More common and more profound in peds
Spinal shock
hemorrhage,
Cardiogenic shock
Hemorrhagic shock