The paediatric assessment triangle: a powerful tool for the prehospital provider

Timothy Horeczko
Thursday, January 13, 2011

The paediatric assessment triangle (PAT) is an internationally accepted tool in paediatric life support for the initial emergency assessment of infants and children. It is a rapid, global assessment using only visual and auditory clues, and takes only seconds to perform. The PAT has three components: appearance, work of breathing and circulation to skin. It is the first step in answering three critical questions: (1) How severe is the child's illness or injury? (2) What is the most likely physiologic abnormality? and (3) What is the urgency for treatment? The combination of abnormalities observed by the three components defines one of six categories of clinical status: stable, respiratory distress, respiratory failure, shock, central nervous system (CNS)/metabolic disorder, or cardiopulmonary failure. The category of illness and its severity drives management priorities and determines the initial treatment. In addition, the PAT provides a common vernacular for emergency clinicians and may be applied repeatedly to track clinical status. This article will furnish the prehospital provider with an approach to the recognition and treatment of the acutely ill or injured child.

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