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

StableRespiratory DistressRespiratory FailureShockCentral Nervous System/Metabolism
of patient
Work of breathingNormalAbnormalAbnormalNormalNormalAbnormal
Circulation to skinNormalNormalNormal/abnormalAbnormalNormalAbnormal


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


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