Pediatric emergency medicine trisk 0133 0133
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Primary Survey
Once the overall urgency of care is determined through the PAT, the triage
provider should complete a more detailed assessment of the patient’s airway,
breathing, circulation, disability, and exposure. This examination should be done
in the specified order so that life-threatening findings are systematically identified
and the patient immediately moved for appropriate intervention. As a general
rule, any pediatric assessment should be completed from least invasive to most
invasive to keep the child calm and allow for accurate assessment. Permit the
child to remain as close as possible to their care provider, utilizing
developmentally appropriate instruction and distraction to increase comfort,
cooperation, and trust. Table 6.4 outlines the goals and “red flag” signs and
symptoms of the primary survey.
Secondary Survey
The triage secondary survey centers on obtaining pertinent information about the
patient’s presentation to the ED and past medical history, with an additional
focused physical assessment based on chief complaint. The patient’s chief
complaint is the subjective reason for visit provided by the patient or care
provider. History taking in triage must be brief, with data obtained from the
child’s accompanying care provider, or the child if possible. Adolescents should
be interviewed separately when presenting with mental health or sexual
complaints. The secondary survey should also include an initial pain assessment
utilizing developmentally appropriate scoring tools.
TABLE 6.5
CIAMPEDS
C
I
A
M
P
E
D
S
CIAMPEDS
Chief complaint
Immunizations and isolation (assess need for )
Allergies (food, medications, dyes, latex, blood )
Medications (current )
Past medical history
Events surrounding the illness or injury
Diet and diapers (PO intake and urine output )
Symptoms associated with illness or injury
