Table 1 Inclusion and exclusion criteria

• Trauma patients 1 year old to 15 years old admitted to the PICU

• Post-operative patients 1 year old to 18 years old admitted to the PICU–general surgery, urology, orthopedic patients

• Patients admitted to the PICU directly from the ED

• Patients admitted to the PICU from the OR

• Patients transferred to PICU from outside facility ER (need to have been in ER 12 h or less)

• Patients transferred to PICU from outside PICU or floor

• Patients transferred to PICU from outside ER if > 12 h

• Patient with congenital heart disease as defined by a congenital cardiac defect requiring surgery or medication

• Patient with a diagnosis of a chronic cardiac condition (e.g. hypertension, cardiac arrhythmia)

• Patients with chronic kidney disease as defined by an abnormality of kidney stricture or function, present for more than 3 months, with implications for health

• Post-operative transplant, cardiac, and neurosurgical patients

• Patients with traumatic brain injury

• Patients with any disease that may affect baseline blood pressure and heart rate (endocrine disorders, certain genetic disorders, mitochondrial diseases)

• Hypotension requiring vasopressor therapy

• If a massive transfusion protocol initiated