Which of the following signs indicates good perfusion during pediatric resuscitation?

• A. Pulses, improved capillary refill, warmer skin, and signs of perfusion improvement; improved mental status may indicate ROSC.
• B. Cold skin with delayed capillary refill.
• C. No change in perfusion.
• D. Worsening pulses despite CPR.

Answer: (A)

In pediatric resuscitation, signs that perfusion is improving reflect that blood is reaching tissues and organs. Palpable pulses show forward blood flow, faster capillary refill indicates better peripheral perfusion, and warmer, pinker skin suggests improved circulation. If brain perfusion improves, you may also see an improvement in mental status, which can point to return of spontaneous circulation. The other signs describe poor or unchanged perfusion: cold skin with delayed capillary refill signals poor perfusion; no change or worsening pulses indicate ongoing instability.