1. Inspection

   1. Dry mucus membrane
   2. Dry axillae
   3. Tongue furrows/fissures
   4. Sunken eyes
   5. Confusion
   6. Aphasia (word-finding difficulty)

2. Vitals

   • Pulses
     • Progressive disappearance of pulse: radial → femoral → carotid
       • no femoral pulse = sBP < 60 mmHg
     • ↑ Tachycardia (>150)
   • Rapid RR
   • Hypotension ↓(<90/60)
   • Capillary refill > 5s

3. Postural vitals

   1. Supine → 2 min → Measure HR (30 min) and BP
   2. Upright* → 1 min → Measure HR (30 min) and BP

   *Standing, not sitting

   • Postural change indicate hypovolemia (Orthostatic hypotension

     <aside> 💡 HR ≥ 30/min → INCREASE

     </aside>

     <aside> 💡 sBP ≥ 20 mmHg → DROP

     </aside>

     <aside> 💡 dBP ≥ 10 mmHg → DROP

     </aside>

4. JVP below the sternal angle

   

<aside>

1. Other assessments
   • U/O - Urine output (0.5-1 cc/kg/h) low
   • IVC Scan </aside>

Newborn

• !Neonatal Sepsis
• Depressed Fontanelle in baby (Fontanelle Exam)