Prehospital Physical Assessment and Critical Interpretation of Vital Signs

Questions and Answers

1 Why is it important to have a systematic approach to the evaluation of a seriously ill or injured child?

It is important because it will help the provider quickly recognize clear signs of respiratory distress, respiratory failure, and shock, as well as immediately provide lifesaving procedures once these signs are identified.

2 According to the American Heart Association (AHA) Pediatric Advanced Life Support (PALS), how should you initially evaluate a patient to help you identify quickly what type of physiologic problem the patient is having?

Your initial impression should include the patient’s appearance (tone, ability to interact, consolability, look/gaze, speech/cry), circulation (see question 4), and work of breathing (abnormal breath sounds, abnormal positioning, retractions, nasal flaring). This is otherwise known as the Pediatric Assessment Triangle (PAT). The PAT will help the provider quickly identify if the problem is respiratory, circulatory, or neurologic, as well determine the urgency of treatment and transportation.

3 If the child’s condition is identified as life threatening, what are the next steps that should be followed?

You should start life support interventions. For example, in a patient that is unresponsive with agonal breaths with pulse less than 60/min, it is imperative that the provider start cardiopulmonary resuscitation (CPR) immediately, starting with chest compressions.

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