Paediatric Emergencies for Paramedics
Sick children are not small adults. Build confidence with the Paediatric Assessment Triangle, age-appropriate vital signs, and common childhood emergencies.
Start Free TodayWhy Paediatric Emergencies Feel Different
Many paramedics find paediatric emergencies among the most stressful calls they attend. Children's physiology is genuinely different from adults — their compensatory mechanisms are more effective (masking deterioration until it's severe) and their anatomy presents different airway challenges.
The good news: the same systematic approach applies. The key is knowing the paediatric-specific tools — particularly the Paediatric Assessment Triangle for rapid initial assessment.
Children Compensate Well — Until They Don't
A child can maintain near-normal vital signs while significantly unwell, then deteriorate rapidly and catastrophically. Treat clinical appearance and work of breathing as highly significant — don't be falsely reassured by a normal heart rate or BP in a child who looks unwell.
The Paediatric Assessment Triangle (PAT)
Appearance (TICLS)
Tone — muscle tone appropriate for age? Interactivity — engaging with environment? Consolability — can be comforted? Look/gaze — alert and tracking? Speech/cry — normal quality?
Work of Breathing
Abnormal sounds (stridor, wheeze, grunting), abnormal positioning (tripoding), retractions (subcostal, intercostal, sternal), nasal flaring, and head bobbing. These visual signs indicate respiratory distress without needing to auscultate.
Circulation to Skin
Pallor, mottling, cyanosis. Assessed visually. Combined with appearance and work of breathing, the PAT gives a rapid global impression in under 30 seconds.
Common Paediatric Presentations
🤒 Febrile Convulsions
Common under 5. Usually brief (<15 mins), self-limiting. Prolonged = status epilepticus. Temperature management.
🌬️ Bronchiolitis
RSV in infants under 1. Wheeze, recession, poor feeding. Mainly supportive management.
🔊 Croup
Barking cough, stridor, hoarse voice. Viral laryngotracheobronchitis. Severity assessment is key.
🫁 Paediatric Asthma
Wheeze, breathlessness, tachycardia. Severity assessment using PEFR in older children.
🦠 Meningitis/Sepsis
Non-blanching rash, fever, photophobia, stiff neck, altered consciousness. Time-critical — rapid recognition and transport.
🩺 Anaphylaxis
Same recognition principles as adults — urticaria, angioedema, bronchospasm, cardiovascular compromise. Rapid identification is critical.
Paediatric Revision Tools
AI Patient Scenarios Pro
Practise paediatric emergency scenarios — from febrile convulsions to bronchiolitis — in a safe environment that builds confidence before real calls.
Chat with Hollie Free
Ask Hollie to explain the PAT, quiz you on normal paediatric vital signs, or walk through the assessment of any common childhood presentation.
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Frequently Asked Questions
How do paramedics assess a sick child?
Paramedics use the Paediatric Assessment Triangle (PAT) for a rapid, hands-off initial impression: Appearance (TICLS: Tone, Interactivity, Consolability, Look/gaze, Speech/cry), Work of breathing (visual signs of respiratory distress without auscultation), and Circulation to skin (colour, mottling, pallor). This takes under 30 seconds and tells you immediately if the child is stable, ill, or critically unwell.
What vital signs are normal for children?
Normal vital signs vary significantly with age. Respiratory rate, heart rate, and blood pressure all change as children grow — RR and HR are higher in young children and decrease with age. Always use an age-appropriate reference when assessing paediatric patients.
What are the most common paediatric emergencies for paramedics?
Common paediatric emergencies include febrile convulsions, bronchiolitis, croup, asthma, anaphylaxis, hypoglycaemia, meningitis, and trauma. Sudden infant death syndrome (SIDS) and non-accidental injury also fall within paramedic practice. Recognition and management of the septic child is increasingly important.