Parameter Comment Heart rate Tachycardia can be a sign of Age related ( hypovolemia or ongoing shock; Table 10.7 ) bradycardia can be a sign of shock in infants or neurogenic shock in older children Tachypnea indicates pulmonary disease Age related ( or reflects an increasing metabolic Table 10.7 ) acidosis Hypotension may not be evident early Age related ( in compensated shock, especially in Table 10.7 ) infants/young children A wide pulse pressure (DBP 2–4 mmol/L may be