Physical findings of volume depletion in infants and children

Finding	Mild (3 to 5%)	Moderate (6 to 9%)	Severe (≥10%)
Pulse	Full, normal rate	Rapid*	Rapid* and weak or absent
Systolic pressure	Normal	Normal to low	Low
Respirations	Normal	Deep, rate may be increased	Deep, tachypnea or decreased to absent
Buccal mucosa	Tacky or slightly dry	Dry	Parched
Anterior fontanelle	Normal	Sunken	Markedly sunken
Eyes	Normal	Sunken	Markedly sunken
Tears (in infants)	Present	Decreased	Absent
Skin turgor	Normal	Reduced	Tenting
Skin temperature and appearance	Normal	Cool	Cool, mottled, acrocyanosis
Urine output	Normal or mildly reduced	Markedly reduced	Anuria
Systemic signs	Increased thirst	Listlessness, irritability	Grunting, lethargy, coma

* Tachycardia may be the first sign of hypovolemic shock in infants.

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