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Please wait while the page loadsClinical Skills · Paediatric Assessment
A systematic approach to assessing any acutely unwell child. Work through each step in order — and always return to A after intervening. Covers airway, breathing, circulation, disability, and exposure with paediatric-specific values, red flags, and clinical pearls.
Reassess always
After every intervention, return to A before moving to the next step. Never skip ahead.
PEWS score
Calculate the Paediatric Early Warning Score at each assessment. A score ≥3 triggers escalation.
Escalate early
Children deteriorate fast and compensate silently. Don't wait for confirmation — act on instinct.
Parents know
If a parent says their child is not right, take it seriously. They know their child's baseline.
Is the airway open and protected?
Look
Listen
Feel
Act
Red flags
Clinical pearl
In children the narrowest point is the cricoid ring (not the cords) — even mild swelling significantly reduces airway diameter. In anaphylaxis, give IM adrenaline early without waiting for full symptom progression.
Is breathing adequate in rate, depth, and effort?
Rate & pattern
Inspect
Auscultate
Act
Red flags
Is cardiac output adequate to perfuse end organs?
Pulse & BP
Perfusion
Monitoring
Act
Red flags
Clinical pearl
Children compensate remarkably well — then crash suddenly. Do not wait for hypotension before escalating. Fluid bolus in children is 10 ml/kg (not the adult 250 ml). Reassess after every bolus.
What is the neurological status and blood glucose?
Consciousness
Glucose
Pupils & fontanelle
Act
Red flags
What has been missed? Inspect thoroughly but maintain dignity.
Inspect
Temperature
Lines & drains
Chart review
Red flags
Reassess & escalate
Document & monitor