👤 Jaylen, 2, pale and listless

HR 180. BP 70/50. Pale, mottled skin. Cap refill 4 seconds. Cool to mid-calf.

Pulse pressure: 20 mmHg (narrow). Weak thready pulses. Demarcation line at mid-calf.

Diagnosis: COLD SHOCK — community-acquired sepsis.

Epinephrine started at 0.1 mcg/kg/min. "COLD needs the HEAT."

Response tracked by demarcation line: mid-calf → ankle. Warming extremities = improving perfusion.