A four-month-old boy is brought in by his parents for severe difficulty breathing. He is a bounce back from an ED visit 3 days ago. His previous ED visit diagnosis was bronchitis and he was sent home with antibiotics. He is lethargic and lacks muscle tone. He is tachypnic with significant retractions and shallow respirations. He is pale and is exhibiting peripheral cyanosis. His VS are T97.0, RR 61, HR 161, B/P 102/p, Saturation 82%. a. What is the overall impression? b. What does the PAT tell y
Answer (1)
a. What is the overall impression?The four-month-old boy is critically ill. He presents with signs of respiratory failure, poor perfusion, and possibly sepsis or a progressing respiratory illness that was underdiagnosed as bronchitis.Key signs:Lethargy and low muscle tone → poor neurological statusTachypnea with retractions and shallow breathing → severe respiratory distressPeripheral cyanosis and pale skin → poor oxygenation and perfusionOxygen saturation at 82% → hypoxiaPrevious ED visit with no improvement → progression despite antibioticsb. What does the PAT (Pediatric Assessment Triangle) tell you?PAT evaluates:Appearance – The baby is lethargic with poor muscle tone → abnormalWork of Breathing – Tachypnea, retractions, shallow respirations → increased work of breathingCirculation to Skin – Pale, peripheral cyanosis → poor perfusionPAT result: The child is unstable and in critical condition. Immediate interventions like oxygen support, potential intubation, and emergency transport are required.
