Paramedic National Registry Practice

In children, what is commonly assessed when determining the presence of shock?

1. Respiratory rate

2. Capillary refill time

3. Temperature

4. Pulse rate

The correct answer is: Capillary refill time

When assessing children for the presence of shock, capillary refill time is a commonly used indicator. This assessment involves pressing on a child's nail bed or skin to blanch it, then observing how quickly the color returns. A prolonged capillary refill time (greater than 2 seconds) can be a sign of inadequate perfusion and may indicate shock. This is particularly relevant in pediatric patients, as they often compensate for shock effectively until they reach a critical state; thus, subtle signs like capillary refill can provide early insights into their cardiovascular status. While respiratory rate, temperature, and pulse rate are all important components of a pediatric assessment, they can be influenced by various factors and may not be as specific to identifying shock. For instance, respiratory rate may vary based on activity level or anxiety, while pulse rate can also be affected by fever or excitement. Temperature gives an overall picture of the child's current state but does not directly indicate perfusion status. Therefore, capillary refill time is prioritized for evaluating shock in children due to its direct correlation with blood flow and perfusion.