Reviewer analysis for antecedents
| Antecedent | Description |
| Acute change in vital signs outside normal range for patient age | A change in respiratory rate, blood pressure, heart rate to a level outside of normal range for age according to reference tables in the Harriet Lane Handbook26 and Pediatric Resuscitation Card27 |
| Change in respiratory pattern | Documentation of increased work of breathing, threatened airway, stridor, retractions, nasal flaring or grunting |
| Mental status changes | Documentation of lethargy, difficulty to arouse, confusion, agitation |
| New desaturation to <90% in patients without cyanotic heart disease or <70% in patients with cyanotic heart disease | Documentation of oxygen desaturation detected by pulse oximetry to <90% in patients without cyanotic heart disease or <70% in patients with cyanotic heart disease |
| Repeated or prolonged seizures | Seizure activity documented in medical record occurring more than once in 24-h chart review period or documented as lasting 5 min or longer |
| Documented concern or worry about patient’s condition | Concern (leading to notification of a physician) documented in medical record nursing notes or physician progress notes without the presence of any of the other antecedents |