2 - Pediatric Assessment

factors in high-risk pregnancies

• maternal age <18 or >35 years

• HTN

• DM

• infections

• substance use

common complications during pregnancy

• placenta previa

• placental abruption

• pre-eclampsia/eclampsia

• HELLP syndrome

• fetal growth restriction

prenatal tests

• ultrasound

• fetal heart monitoring

• non-stress test

• biophysical profile

pediatric assessment triangle (PAT)

quick audiovisual tool

3 elements:

• appearance

• WOB

• circulation to skin

PAT: appearance (TICLS)

• Tone

• Interactiveness

• Consolability

• Look/gaze

• Speech/cry

PAT: work of breathing

signs

• nasal flaring

• grunting

• chest retractions

• head bobbing

sounds

• stridor

• wheezing

• gasping

PAT: circulation to skin

• cyanosis

• pallor

• mottling

• delayed capillary refill

ABCDE survey

neonatal assessment tool

• Airway

• Breathing

• Circulation

• Disability

• Exposure/Environment

ABDCE: airway

• stridor

• drooling

• silent airway

• obstructions

  • choanal atresia (nasal blockage)

  • macroglossia (large tongue)

  • mandibular hypoplasia (small jaw)

ABCDE: breathing

• respiratory rate, effort, pattern

• accessory muscle use

• chest symmetry

• S_pO₂

ABCDE: circulation

• HR, RR, perfusion

• skin color and temperature

• shock

  • cold extremities

  • poor refill

  • hypotension

ABCDE: disability

• neurologic assessment: AVPU

  • alert

  • verbal

  • pain

  • unresponsive

• bulging fontanelles: increased ICP

• seizures

ABCDE: exposure/environment

• expose baby to check for trauma/rash

• maintain temperature control

SAMPLE history

• Signs/Symptoms

• Allergies

• Medications

• PMH

• Last meal

• Events leading up to…

respiratory distress

• tachypnea

• retractions

• nasal flaring

• normal LOC

• good air entry

respiratory failure

• bradypnea

• cyanosis

• ABG changes

• altered LOC

• poor air entry

RT actions in pediatric assessment

• escalate care when signs of respiratory failure appear

  • CPAP/intubation

• monitor trends in vital signs

• document WOB consistently

diagnostic tools for pediatric assessment

• pulse ox

• capnography

• CXR

• ABG