Which are typical early signs of Distributive (Disruptive) shock in children?

• A. Warm, flushed skin and bounding pulses
• B. Cool, mottled skin
• C. Pale mucous membranes with delayed cap refill
• D. Hypotension without tachycardia

Answer: (A)

In distributive shock in children, early signs come from vasodilation with preserved or high cardiac output, so the skin feels warm and flushed and the pulse often feels strong and bounding. This reflects the body trying to maintain perfusion despite abnormal distribution of blood flow. As shock progresses, perfusion drops: you’d see cool, mottled skin, pale mucous membranes with delayed cap refill, and eventually hypotension, but these are later findings. So the warm, flushed skin with a bounding pulse is the best indicator of the early distributive-shock stage.