Systems review

• Assessing respiratory effort:

  • Mild respiratory distress: nasal flaring, subcostal recession
  • Moderate respiratory distress: head bobbing, tracheal tug, intercostal recession, inspiratory or expiratory noises
  • Severe respiratory distress: sternal recession, grunting, exhaustion, impending respiratory arrest
• Clinical features of dehydration include:

  • Tachycardia
  • Reduced skin turgor
  • Reduced urine output
  • Sunken eyes
  • Dry mucous membranes
  • Altered responsiveness
• Clinical features of shock include:

  • Decreased conscious level
  • Mottled skin
  • Cold peripheries
  • Prolonged capillary refill time
  • Pronounced tachycardia and hypotension