a persistent systolic BP below 90mmHg or drops more than 40mmHg below their baseline, or a mean arterial pressure (MAP) below 65mmHg is highly suggestive of shock
a person can be in shock with a normal BP if that BP is unable to maintain tissue perfusion
healthy young adults can maintain their BP and heart rate much longer which can hide underlying shock state!
check for evidence of shock: serum lactate, urine output, tachycardia, cold, clammy skin, pale lips, shallow rapid breathing, etc
check for causes including less evident ones such as occult bleeding (eg. ruptured ectopic pregnancy), cold sepsis, PE
a Shock Index (heart rate/systolic BP) > 0.7 suggests early shock and if > 1.0 suggests a shock state
these patients usually need to be moved to a resuscitation cubicle for urgent care