would require immediate attention and intervention: ‐ Pallor: White or pale skin or mucous membranes
‐ Mottling: Patchy, lacy skin discol‐ oration due to vasoconstriction
‐ Cyanosis: Bluish discoloration of skin and mucous membranes
Other Assessment Considerations and Strategies
Assessments and interventions must be tailored to each child in terms of age, size, development and metabolic sta‐ tus. Approaching an alert child too fast may cause crying and agitation, which interferes with assessment and may increase respiratory distress.
“TICLS” Mnemonic
for Assessment Features to look for:
Tone ‐ Extremities move spontaneously with good muscle tone; child should not be flaccid or move only to stimuli Interactive ‐ Responds to environmen‐ tal stimuli or presence of caregiver or stranger; child should not be listless, obtunded or lethargic Consolable ‐ Easily comforted or calmed by caretaker (i.e., speak softly, hold child, or offer a pacifier) Look/Gaze ‐ Maintains eye contact with objects or people; child should not have a glassy‐eyed stare Speech/Cry ‐ Present, strong and spon‐ taneous; speech or cry should not be muffled, weak, or hoarse
The PAT is an excellent tool for a first look at “How Sick or How Quick” the pediatric patient is and gives highly sen‐ sitive information on a child's status in a short period of time. The PAT is taught and promoted in major pediatric cours‐ es as a standard tool in the emergency assessment of the sick or injured child or infant.
To learn more about the National Association of Emergency Medical Technicians (NAEMT) Emergency Pediatric Care course, go to the Education section of
www.naemt.org.
EMS
EMSPROMAG.com 23
Bibliography Pediatric Assessment. Emergency Pediatric Care course slides, NAEMT, 2010
Beyond the Basics: Pediatric Assessment. Krost, Mistovich, Limmer. EMS World, 2010
The Pediatric Assessment Triangle: A Novel Approach for the Rapid Evaluation of Children Dieckmann, Brownstein, Gausche-Hill. Pediatric Emergency Care: April 2010
American Academy of Pediatrics and American College of Emergency Physicians. APLS: The Pediatric Emergency Medicine Resource, 4th Edition. Sudbury: Jones and Bartlett, 2004.
American Academy of Pediatrics. Pediatric Education for Prehosptal Professionals. Sudbury: Jones and Bartlett, 2000.
American Heart Association. PALS Provider Manual, American Heart Association, 2005.
Bledsoe , Porter , Cherry . Paramedic Care: Principles and Practice. Volume 2. Patient Assessment, 2nd Edition. Upper Saddle River: Prentice-Hall, 2006.
Bledsoe, Porter, Cherry. Paramedic Care: Principles and Practice. Volume 5. Special Considerations, 2nd Edition. Upper Saddle River: Prentice-Hall, 2006.
Dietrich , Shaner , Campbell . Pediatric Basic Trauma Life Support, 2nd Ed. Oak Terrace: Basic Trauma Life Support International, 2002.
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