Table 4. Haemodynamic assessment-continuum of haemodynamic changes.

Parameters	Stable circulation	Compensated shock	Hypotensive shock
Conscious level	Clear and lucid	Clear and lucid	Restless and combative
Capillary refill time	Brisk (<2 seconds)	Prolonged (>3 seconds)	Very prolonged and mottled skin
Extremities	Warm and pink	Cool peripheries	Cold and clammy
Peripheral pulse volume	Good volume	Weak and thready	Feeble or absent
Heart rate	Normal heart rate for age	Tachycardia	Severe tachycardia or bradycardia in late shock
Blood pressure	Normal blood pressure for age	Normal systolic pressure but rising diastolic pressure	Hypotension (see definition below)
	Normal pulse pressure for age	Narrowing pulse pressure (≤20 mm Hg) Postural hypotension	Unrecordable blood pressure
Respiratory rate	Normal respiratory rate for age	Tachypnoea	Hyperpnoea or Kussmaul’s breathing (metabolic acidosis)
Urine output	Normal	Reducing trend	Oliguria or anuria

*There are 8 parameters to be assessed: 3 of them relate to peripheral perfusion (capillary refill time, colour and temperature of extremities, and peripheral pulse volume), 2 to the cardiac output (heart rate and blood pressure), 2 to organ perfusion (brain and kidney) and 1 to respiratory compensation for shock. By holding patient’s hand, you can evaluate 4 of these parameters