Traditionally, Clinical Decision Support Systems (CDSS) collect patient data from physiological monitors and other sources, providing clinicians with derived instructions and information to aid treatment planning. With advancements in telecommunication networks, CDSS functionality can be extended over distances, and accessed remotely (e.g, by appropriate healthcare providers not available in the patient's immediate surroundings). This paper discusses a modular CDSS that features real-time continuous patient monitoring, high-fidelity analysis and incorporation of clinical guidelines for decision support. A modular CDSS prototype was designed, implemented and tested in a pediatric intensive care environment, by incorporating a guideline for pediatric traumatic brain injury (TBI). System outputs show successful aggregation and analysis of continuous and periodic data, and automation of guidelines by recognizing deviation of patient's condition from normal states. The modular design will allow extension into pre-hospital treatment environments by taking advantages of advances in pervasive monitoring.