A to E Assessment- Child Specific
A- Airways
B- Breathing
C- Circulation
D- Disability
E- Exposure
The ABCDE approach is the most recognised tool for rapid patient assessment, it allows us to
recognise life-threatening conditions early and provides a systematic method that focuses on
identifying problems and implementing critical interventions in a timely manner.
- The A to E assessment is suitable for all age groups, including children from birth to 18 years.
- As long as we know what’s normal, we can access and act on the abnormal.
- The A to E assessment is quick and most of it can be done without any equipment.
Airways- Structures that allow the normal passage of air to flow from the outside of the
body (the lower atmosphere) to the lower respiratory tract (to the lungs to allow the
exchange of oxygen for carbon dioxide).
Signs that a baby or child’s airway is patent?
- Crying
- Talking
- Babbling
Differences in a young child’s airway:
- Tongue larger in proportion of the mouth
- Smaller pharynx
- Large, floppy epiglottis
- Larynx is more anterior and narrowest at the cricoid.
- Trachea is less rigid and more narrow
Breathing- Exchange of carbon dioxide for oxygen to adequately oxygenate the organs and maintain
homeostasis.
Signs of healthy breathing in babies and children:
- Chest is rising and falling
- Breathing is quiet
- Can babble, make sounds/talk depending on age and developmental stage.
- Breathing looks natural
- No unusual sounds
Breathing assessment- Baby/Young child
, - Trachea is shorter in an infant and less rigid
- Division of the trachea into the bronchi is called the carina- this can stimulate the cough
reflex.
- Between 3-4 years is critical for lung development, this is when a child’s lungs start to fully
develop. Most corrective surgeries are performed on children under the age of three.
- Fewer collateral ventilator channels.
- Lungs are anatomically mature at 8 years old.
- Flatter diaphragm in young children.
- Increased demand for oxygen
- Higher respiratory rate means more rapid fatigue.
Normal findings for Breathing & Saturations
- Rate?
- Rhythm
- Appearance
- Saturations
- 95% in air
Respiratory Rates for different ages:
Birth-One years: 30-40 breaths per minute
1–2-year-olds: 25-35 breaths per minute
2-5 years old: 25-30 breaths per minute
5-12 years old: 20-25 breaths per minute
12 and over: 15-20 breaths per minute
C- Circulation
- Heart
- Blood vessels (arteries, veins and capillaries)
What do you consider to indicate good circulation for babies?
- Colour
- Skin tone
- Capillary refill
- Are they cold or warm? Particularly their fingers, hands and feet.
Normal findings for circulation in a Child:
- Rate
- Rhythm
- Colour
- Capillary refill time
- The smaller and younger the child is, the faster their heart rate will be.
Heart Rates for different ages:
A- Airways
B- Breathing
C- Circulation
D- Disability
E- Exposure
The ABCDE approach is the most recognised tool for rapid patient assessment, it allows us to
recognise life-threatening conditions early and provides a systematic method that focuses on
identifying problems and implementing critical interventions in a timely manner.
- The A to E assessment is suitable for all age groups, including children from birth to 18 years.
- As long as we know what’s normal, we can access and act on the abnormal.
- The A to E assessment is quick and most of it can be done without any equipment.
Airways- Structures that allow the normal passage of air to flow from the outside of the
body (the lower atmosphere) to the lower respiratory tract (to the lungs to allow the
exchange of oxygen for carbon dioxide).
Signs that a baby or child’s airway is patent?
- Crying
- Talking
- Babbling
Differences in a young child’s airway:
- Tongue larger in proportion of the mouth
- Smaller pharynx
- Large, floppy epiglottis
- Larynx is more anterior and narrowest at the cricoid.
- Trachea is less rigid and more narrow
Breathing- Exchange of carbon dioxide for oxygen to adequately oxygenate the organs and maintain
homeostasis.
Signs of healthy breathing in babies and children:
- Chest is rising and falling
- Breathing is quiet
- Can babble, make sounds/talk depending on age and developmental stage.
- Breathing looks natural
- No unusual sounds
Breathing assessment- Baby/Young child
, - Trachea is shorter in an infant and less rigid
- Division of the trachea into the bronchi is called the carina- this can stimulate the cough
reflex.
- Between 3-4 years is critical for lung development, this is when a child’s lungs start to fully
develop. Most corrective surgeries are performed on children under the age of three.
- Fewer collateral ventilator channels.
- Lungs are anatomically mature at 8 years old.
- Flatter diaphragm in young children.
- Increased demand for oxygen
- Higher respiratory rate means more rapid fatigue.
Normal findings for Breathing & Saturations
- Rate?
- Rhythm
- Appearance
- Saturations
- 95% in air
Respiratory Rates for different ages:
Birth-One years: 30-40 breaths per minute
1–2-year-olds: 25-35 breaths per minute
2-5 years old: 25-30 breaths per minute
5-12 years old: 20-25 breaths per minute
12 and over: 15-20 breaths per minute
C- Circulation
- Heart
- Blood vessels (arteries, veins and capillaries)
What do you consider to indicate good circulation for babies?
- Colour
- Skin tone
- Capillary refill
- Are they cold or warm? Particularly their fingers, hands and feet.
Normal findings for circulation in a Child:
- Rate
- Rhythm
- Colour
- Capillary refill time
- The smaller and younger the child is, the faster their heart rate will be.
Heart Rates for different ages:
