Which parameter is LEAST reliable when assessing perfusion status in a 2-year-old child with possible shock?

In assessing perfusion status in pediatric patients, especially in young children like a 2-year-old, certain parameters provide more reliable indicators than others. Systolic blood pressure can vary significantly in children and may not accurately reflect their perfusion status in cases of shock.

Children can maintain their blood pressure until they are significantly compromised, meaning that a normal systolic blood pressure could give a false sense of security regarding their perfusion and hemodynamic stability. Therefore, relying solely on blood pressure can be misleading when evaluating shock in this age group.

On the other hand, other parameters such as distal capillary refill time, skin color and temperature, and the presence of peripheral pulses tend to provide a more immediate and reliable assessment of perfusion in children. These factors can often indicate early signs of shock before blood pressure drops, making them more pertinent for the evaluation of a child’s circulatory status.