The No. 1 rule of the pediatric exam

Drs. Dickson and Patrick review the pediatric general assessment triangle

Nothing scares an emergency provider quite as much as the sick infant. 

In this episode of the MCHD Paramedic Podcast, MCHD Medical Directors Dr. Robert Dickson and Dr. Casey Patrick walk through the pediatric general assessment triangle – appearance, work of breathing, circulation – and discuss the finer points that make up each side. 

They’ll also discuss the singular/No. 1 law of the pediatric exam. Your next pediatric run will be a breeze after this review.

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The pediatric general assessment triangle

Go back to the basics with a thorough understanding of pediatric appearance, breathing and circulation warning signs, and the cardinal rule of pediatric assessment


  1. Leeper, Christine M. MD, MS; McKenna, Christine MSN; Gaines, Barbara A. MD Too little too late: Hypotension and blood transfusion in the trauma bay are independent predictors of death in injured children, Journal of Trauma and Acute Care Surgery: October 2018 - Volume 85 - Issue 4 - p 674-678 doi: 10.1097/TA.0000000000001823
  2. Balamuth F, Alpern ER, Abbadessa MK, et al. Improving Recognition of Pediatric Severe Sepsis in the Emergency Department: Contributions of a Vital Sign-Based Electronic Alert and Bedside Clinician Identification. Ann Emerg Med. 2017;70(6):759-768.e2. doi:10.1016/j.annemergmed.2017.03.019

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