Pediatric Assessment Triangle in the Field

Course Overview

The Pediatric Assessment Triangle (PAT) is a rapid, “from the doorway” assessment tool that forms the cornerstone of pediatric emergency care. It allows EMS providers to form a general impression of a child’s physiological state within 30-60 seconds, without touching the patient or using any equipment.

Why Pediatric Assessment Is Different

Children are not “little adults.” Their unique anatomy and physiology mean they present, compensate, and decompensate differently.

• Limited Reserves: Children have less metabolic and oxygen reserve. Hypoxia can develop rapidly.
• Compensation Mechanisms: They primarily compensate for shock and distress by increasing heart rate and respiratory rate. Hypotension is a late and ominous sign.
• Airway Anatomy: Their airways are narrower, softer, and more prone to obstruction.
• Communication Barriers: Infants and toddlers cannot describe their symptoms.

The Three Components of PAT

A) Appearance (TICLS Mnemonic)

This reflects the adequacy of ventilation, oxygenation, brain perfusion, and CNS function:

• T – Tone: Is the child moving actively or limp?
• I – Interactiveness: How alert is the child? Do they track you with their eyes?
• C – Consolability: Can the parent/caregiver console the child when they cry?
• L – Look/Gaze: Does the child make eye contact?
• S – Speech/Cry: Is the child’s cry strong and robust, or weak and muffled?

See full course for complete content including Work of Breathing, Circulation assessment, age-specific considerations, and real-world scenarios.