Primary assessment algorithm / Initial emergency assessment

Last updated: March 15, 2022

In the adult, sudden cardiac death caused by ventricular fibrillation, is the most frequent cause of cardiac arrest. In infants and children, cardiopulmonary arrest is most likely secondary to another condition such as respiratory failure or trauma causing hypovolemia. The primary assessment in pediatrics is very important because it is focused on catching issues that may lead to cardiac arrest before they do so.

The following should be assessed in all children who are suspected to have any grave illness.

1. Abnormal vital Signs (see normal vital sign chart)
2. Irregular respirations
3. Slow or fast heart rate for age
4. Signs of poor perfusion
1. Check for presence or absence of distal pulses
2. Poor skin color
3. Delayed capillary refill
5. Cyanosis or oxygen saturation less than 94%
6. Altered level of consciousness
7. Seizures
8. Fever with petechiae
9. Significant trauma
10. Burns of >10% of body surface area

A positive answer to any of the above may indicate the need for cardiopulmonary support.