Decompensated
Compensatory mechanisms are overwhelmed Heart rate is markedly elevated and hypotension develops Signs and symptoms of organ dysfunction (such as altered mental status as the result of poor brain perfusion) appear Systolicbloodpressurefalls(althoughchildrenwhohavelostasmuchas30%to35%ofcirculatingblood volume can typically maintain normal systolic blood pressures) Once hypotension develops, the child's condition usually deteriorates rapidly to cardiovascular collapse and cardiac arrest