Physical Examination and Clinical Data

The Vital Signs of Decompensation

With the mother's mandate, the grandparents step back, though they remain suspicious. You proceed with the exam. Blood Pressure: 90/70 mmHg.

Analysis: Pulse Pressure = 20 mmHg. This is the definitive sign of Compensated Shock in Dengue. The diastolic pressure rises due to vasoconstriction, while the systolic pressure falls. This is a medical emergency.

• Heart Rate: 130 bpm (Tachycardia - compensatory).
• Respiratory Rate: 32 bpm (Acidotic breathing/central neurogenic hyperventilation).
• Temperature: 37.2°C (Afebrile - Defervescence phase).
• Capillary Refill Time (CRT): 3 seconds (Prolonged - poor perfusion).
• GCS: 9 (E2, V3, M4). Confused, localizes pain, eyes open to pain.