A six-year old girl is brought into the pediatric emergency room by her father. She has a had a 3 day history of low grade fever and vomiting. She has had non-billious, non-bloody emesis 3-5x a day for the past 3 days. There is no history of diarrhea, respiratory symptoms or abdominal pain. She is previously well.

On arrival to the pediatric emergency room, the triage nurse takes her vital signs.
HR: 144
BP: 71/55
Sats: 97% on room air
RR: 28
Temp: 38.2

On examination, she is somewhat drowsy but. Her heart and breath sounds are clear and she is in no respiratory distress. Her abdomen is soft with no masses. Her radial pulses are difficult to find through she has a strong femoral pulse. Her capillary refill is 5-6 seconds.

What is the definition of shock?