- Impaired peripheral arterial tone: sepsis (bacterial most common)
- SIRs for non-infectious reasons
- Meds (e.g. alpha-blockers)
- Autonomic dysfunction (e.g. DM or other neuropathy)
- Metabolic/autoimmune (adrenal insufficiency)
- Chemo therapy (immuno-compromised)
- Age (very young or old)
- Underlying diseases (e.g. post-splenectomy, HIV, cancer, diabetes, etc.)
- Meds which decrease peripheral tone or predispose to infection, other
- Lightheaded, dizzy, weak, confuse
- Cold (hypo-perfusion, hypothermia)
- Hot/febrile (if related to sepsis)
- Loss of consciousness
- Sx exacerbated by moving from lying/sitting to standing→
- May be very ill appearing (depending on etiology)
- May have +orthostatic vital signs
- Depending on cause, periphery can feel warm/moist
- Meds→ alpha blocking agents, other