Pediatric assessment triangle

What is the pediatric assessment triangle (PAT)? 

The PAT is a visual and auditory assessment tool developed for rapid standardized assessment of pediatric patients. As seasoned pediatricians know, you can often identify ill infants and children even without any equipment. The PAT emphasizes a quick evaluation of a patient in three main areas: (1) appearance, (2) work of breathing, and (3) circulation to skin, to form a general impression of the child’s condition. Based on an assessment of normal or abnormal, patients can be categorized in different physiologic categories ranging from “stable” to “respiratory distress” to “decompensated shock” and full “cardiopulmonary failure”. The PAT is now widely accepted and taught to prehospital specialists in pediatric advanced life support (PALS and APLS). To be clear, however, it is an initial quick assessment and not meant to take the place of ABCDEs.

Pediatric Assessment Triangle and Patient General Impression

	Stable	Respiratory Distress	Respiratory Failure	Shock	Central Nervous System/Metabolism Disturbance	Cardiopulmonary Failure
Appearance of patient	Normal	Normal/abnormal	Abnormal	Normal/abnormal	Abnormal	Abnormal
Work of breathing	Normal	Abnormal	Abnormal	Normal	Normal	Abnormal
Circulation to skin	Normal	Normal	Normal/abnormal	Abnormal	Normal	Abnormal

Sources

Adapted from Dieckmann RA, Brownstein D, Gausche-Hill M (eds): Pediatric Education for Prehospital Professionals: PEPP Textbook. Sudbury, MA, Jones & Bartlett Publishers, 2000.