Čes-slov Pediat 2026, 81(4):193-198 | DOI: 10.55095/CSPediatrie2026/036

Primary assessment of the critically ill child in pediatric practicePediatrické postupy v praxi

Markéta Nowaková^{1, 2}, Bořek Trávníček^{1, 2}, Jan Pavlíček¹

¹ Klinika dětského lékařství, Fakultní nemocnice Ostrava a Lékařská fakulta, Ostravská univerzita, Ostrava

² Simulační centrum, Lékařská fakulta, Masarykova univerzita, Brno

Primary assessment of a critically ill child represents a structured approach enabling rapid recognition and immediate management of life-threatening conditions. The article provides an overview of the systematic ABCDE approach based on the recommendations of the European Resuscitation Council which is applicable in both outpatient and hospital pediatric practice.

Initial distant assessment allows rapid estimation of severity by evaluating breathing, body color and behavior. This is followed by a structured primary assessment focusing on airway patency, breathing quality, circulatory stability, neurological status and overall examination including essential

targeted history. The text emphasizes early recognition of respiratory and circulatory failure, the fact that hypotension is a late sign of shock in children, and the necessity of initiating treatment simultaneously with assessment.

The text also highlights the importance of repeated reassessment and structured handover to ensure continuity and safety of care. The aim of the article is to provide pediatricians with a practical and comprehensible tool for the management of critically ill children outside intensive care settings.

Keywords: critically ill child, primary assessment, ABCDE, respiratory failure, shock

Accepted: June 2, 2026; Published: June 1, 2026  Show citation