🧠 The 60-Second Shock Phenotype Check

Four findings. Under one minute. Every reassessment.

1. Cap refill at STERNUM — firm 5s press, count return (>2s = cold, <1s = warm)
2. Pulse quality — weak/thready = cold, bounding = warm
3. Extremity temperature — find the demarcation line (cold-to-warm transition)
4. Pulse pressure — narrow (<20) = cold, wide (>40) = warm

Avoid fingertip cap refill — environmental temp alters results. Use central sites per ACCM guidelines.