Neonate
0 – 28 DaysInfant
1 – 12 MonthsToddler
1 – 3 YearsPreschool
3 – 5 YearsSchool-Age
6 – 12 YearsAdolescent/Teen
≥ 13 YearsCritical Clinical Red Flags (HPCSA)
Infant Heart Rate Trigger
For infants (< 1 yr): HR < 110 bpm is clinically decreased (start thinking hypoxia). HR > 160 bpm is abnormal tachycardia.
Pediatric Bradycardia
HR < 60 bpm in any child with poor perfusion despite adequate oxygenation and ventilation requires immediate CPR.
Thermoregulation & Fever
Recent landmark studies (2023-2024) have proven the 19th-century standard of 37.0°C (98.6°F) is obsolete. The modern baseline human body temperature has dropped to an individualized range closer to 36.6°C (97.9°F).
- < 3 Months Old: Any temp ≥ 38.0°C (100.4°F) is a medical emergency requiring a full sepsis workup.
- 3 - 6 Months Old: Temp ≥ 38.3°C (101°F) warrants urgent evaluation.
CDST (2024-2026) Treatment Snapshot
Temperature Control: Paracetamol (PO/IV) is indicated for symptomatic relief of fever. Specific dosing regimens based on cadre to be fully detailed and discussed in future clinical modules. [Qualification: ANT, ECP]
Oxygenation & Ventilation
Pulse Oximetry (SpO₂)
End-Tidal Capnography
CDST v1.3 Treatment Snapshot
- Oxygen Therapy: Titrate supplemental oxygen to achieve and maintain a target SpO₂ of 94–98% for most acutely ill patients (or 88–92% for known COPD/chronic hypercapnia). Routinely avoid hyperoxia. [Qualification: All Cadres (BAA – ECP)]
- Capnography Mandate: Continuous waveform capnography (ETCO₂) is strictly mandated to confirm and continuously monitor endotracheal tube (ETT) placement, advanced supraglottic airways, and to assess CPR compression quality. [Qualification: ECT, ECA, ANT, ECP]
Clinical Rule: Never Treat the First Blood Pressure Reading Alone
Per the American Heart Association (AHA) and SPRINT clinical guidelines, a single initial blood pressure reading is virtually always falsely elevated and should never dictate critical treatment decisions. In clinical studies, systolic blood pressure drops by 8 to 15 mmHg on the second reading simply due to physiological normalization.
The 3-Step Protocol
- 1Take Reading 1: Acknowledge the number, but treat it as an initial baseline scout.
- 2Wait 60 to 90 Seconds: Leave the deflated cuff in place. Ensure the patient is seated/supine, uncrossed legs, arm supported at heart level, with zero talking.
- 3Take Reading 2: Use the second reading (or average of readings 2 and 3) as your true operational hemodynamic baseline.
The Pathophysiology
The initial cuff inflation triggers an involuntary sympathetic alerting response (transient catecholamine release causing peripheral vasoconstriction). By the second reading, sympathetic tone dampens, vessel compliance normalizes, and white-coat artifact is stripped away—preventing dangerous over-treatment with antihypertensives or misdiagnosing a false hypertensive emergency.
CDST (2024-2026) Treatment Snapshot
Hypertension Management: Pre-hospital acute lowering of blood pressure is generally contraindicated unless there is a specific true hypertensive emergency with target organ damage (e.g., severe pre-eclampsia/eclampsia utilizing MgSO4). Detailed management algorithms will be discussed in future modules. [Qualification: ECA, ANT, ECP]