Global assessments

Parental concerns

Physician instinct

Child behavior

Changes in crying pattern

Drowsiness

Inconsolability

Moaning

Circulatory/respiratory

Crackles

Cyanosis

Decreased breath sounds

Poor peripheral circulation

Rapid breathing

Shortness of breath

Other factors

Decreased skin elasticity

Hypotension

Meningeal irritation

Petechial rash

Seizures

Unconsciousness