A 1-month-old presents with a 3-day history of fever, nausea, and vomiting.

In neonates and young infants,hypoventilationanddecreased level of consciousness (LOC)are late and critical signs ofdecompensationin systemic infection or shock. A progression from normal respiratory rate tohypoventilation, especially with altered LOC, indicatesimpending respiratory failure or septic shock.

“Hypoventilation and changes in mental status (such as lethargy or decreased LOC) are indicators of deterioration in infants with sepsis or dehydration. Immediate intervention is required to prevent arrest.”

(Referenced from CCRN Pediatric – Direct Care: Multisystem, Pediatric Sepsis and Deterioration Cues)