In an emergency medicine patient, accurate measurement of change or lack thereof from non-shock, non-ischemic, non-inflammation, non-tissue injury, non-immune dysfunction conditions is important and is provided, as practical, real-time approaches for accurately characterizing a patient's condition, using Raman (3) and/or fluorescence (30) spectroscopy with a high degree of accuracy. Measurement times are on the order of seconds. High-accuracy measurement is achieved with Raman spectroscopy interrogation of tissue. Simultaneous interrogation by NADH fluorescence spectroscopy may he used. Measurements may be non-invasive to minimally invasive. Preclinical (ultra-early) states of shock can be detected (5), severity can be determined, effectiveness of various treatments can be determined.