The Assessment Sequence

Quick and systematic assessment is critical in pediatric emergencies. The PALS approach uses two essential steps: the primary assessment and the secondary assessment.

Primary Assessment: ABCDE

• Airway: Is it open and clear?
• Breathing: Is the child breathing effectively?
• Circulation: Is there a pulse? Is the skin pink and warm?
• Disability: Is the child alert or responsive?
• Exposure: Look for injuries, rashes, or causes.

This step helps identify and treat immediate life threats.

Secondary Assessment

After initial stabilization, gather more information:

• Focused medical history (SAMPLE: Signs/Symptoms, Allergies, Medications, Past medical history, Last meal, Events)
• Physical examination from head to toe

Using the Assessments

These assessments guide the entire treatment—reassess and adjust care as the child responds.