Cocchi et al reported findings associated with hypoperfusion in a trauma patient. These may indicate that the patient has or is at risk for shock. The authors are from Beth Israel Deaconess Medical Center, Indiana University, and Harvard School of Medicine.

Clinical findings associated with hypoperfusion:

(1) cool and clammy skin

(2) confusion, lethargy, obtundation, coma or other change in mental status

(3) decreased urine output

(4) prolonged capillary refill

(5) bradycardia or tachycardia

(6) hypotension

(7) tachypnea

(8) hypothermia

(9) shock index > 0.9

(10) metabolic acidosis

(11) elevated serum lactate concentration

(12) elevated serum base deficit


The presence of normal vital signs does not exclude the presence of hypoperfusion.

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