COPR Emergency Medical Responder (EMR) Practice Exam

Which sign is most reliable as an early indicator of shock in children?

Tachycardia is a more reliable early sign of shock in children. Hypotension occurs early, before tachycardia. Bounding pulses are common. Fever is an early sign.

Correct Answer:

Fever is an early sign.

Explanation:

In children, the body's first fix for reduced perfusion is to speed up the heart. This makes tachycardia the most reliable early sign of shock, because the heart is compensating to maintain blood flow to vital organs even while perfusion is dropping. Blood pressure tends to stay normal until late in the process, so hypotension is a late indicator and should not be relied on to catch shock early. Bounding pulses aren’t typical early signs of pediatric shock and can occur in other situations, while fever points to infection rather than being a direct early signal of shock. So an increasing heart rate, often with other clues like rapid breathing, cool/clammy skin, and slowed capillary refill, is the best early cue that a child may be going into shock.

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