How to use the pediatric assessment triangle
Other platforms explain it with text and video. In VMS you practice it on the patient.
The pediatric assessment triangle tells you how sick a child is before you touch them.
Step by step
Appearance
Tone, interaction, consolability, look or gaze, speech or cry. [1]
Work of breathing
Abnormal sounds, positioning, retractions, flaring, head bobbing. [1]
Circulation to skin
Pallor, mottling, blue color. [1]
Put it together
Breathing only: distress. Breathing and appearance: failure. Circulation: shock. Appearance only: brain or metabolic problem. [1]
Act
Start treatment and the hands-on assessment. [1]
Common errors
- Waking or upsetting the child first.
- Ignoring appearance.
- Not repeating it.
Practice it in VMS
In VMS you do this on the patient, not on paper: every step goes on the checklist with a score, and in Teach mode Blocky tells you what comes next.
VMS cases that train this skill
Sources
Facts and steps follow NASEMSO National Model EMS Clinical Guidelines; NREMT psychomotor skill sheets (EMT and Paramedic). VMS is not affiliated with these organizations. Updated: 2026-10-11.