Educational draft · awaiting clinical reviewUse Rapid for revision, not patient-care decisions. Check current national and local guidance and the BNF or BNFC before acting.
2 min synopsisUK scopeSources checked 27 Aug 2026Clinical review pending
!
Unwell child during assessment
History-taking must stop when appearance, breathing, circulation or consciousness indicates physiological instability.
Action: Call for paediatric help, begin a rapid first-look assessment and ABCDE, attach age-appropriate monitoring and give time-critical treatment. Obtain only the focused history needed for allergies, medicines, onset, ingestion, trauma and relevant background while resuscitation proceeds; do not separate a frightened child from their caregiver unless access, safety or safeguarding requires it.
Synopsis
Take a developmentally appropriate history, examine a child with minimal distress, integrate parent and child accounts and identify illness, safeguarding and developmental concerns across age groups.
Observe before touching: interaction, colour, posture, spontaneous movement, cry or speech and work of breathing provide high-value information before distress changes physiology.
Use three sources deliberately: the child's account, the caregiver's longitudinal knowledge and the clinician's observations; record who supplied each important fact.
Open with the child when development permits, then clarify with the caregiver without correcting or dismissing either account in front of them.
Key red flags
Reduced interaction, weak cry, abnormal tone, persistent inconsolability, cyanosis, grunting, apnoea or poor perfusion overrides a reassuring verbal history.
Investigation priorities
01
First-line: unobtrusive observationFirst stepFirst line
Assess appearance, interaction, breathing, colour and movement before distress alters findings.
02
First-line: age-adjusted observationsFirst line
Quantify temperature, pulse, respiratory rate, oxygen saturation, blood pressure and consciousness where indicated.
Management branches
Opening assessmentObserve, include and prioritise
Any child arrives for clinical assessment.
Observe appearance, breathing and circulation before approaching and decide whether ABCDE is needed immediately.
Introduce yourself to child and caregiver, establish relationship and parental responsibility and identify communication needs.
National guidance is shown before implementation-dependent detail. Typical adult dose examples remain subject to patient factors, contraindications and the live BNF or specialist protocol. Source check completed 27 Aug 2026; clinical approval remains outstanding.