Pediatric

Children can deteriorate before a blood pressure, oxygen saturation, or complete history is available. The Pediatric Assessment Triangle (PAT) was designed so that a clinician could recognize a critically ill or injured child at first sight, before vital signs or equipment were available. It is a purely observational, hands-off tool, and it is usually completed in about 30 seconds; published estimates run from 30 to 60 seconds. The nurse observes the child before allowing a lengthy history or examination to delay recognition of danger. PAT answers one question: does this child look well, at risk, or critically ill? It does not identify the diagnosis and does not replace the primary assessment. It works like an alarm: it signals urgency, and further assessment is needed to find and treat the cause. The three domains are Appearance, Work of Breathing, and Circulation to Skin. Each domain is judged normal or abnormal as a whole; do not count individual signs as though each were a separate PAT component. The pattern of which domains are abnormal is what carries meaning. Three tools are easy...