The Three Parts
The triangle includes appearance (tone, interactiveness, consolability, look or gaze, and speech or cry), work of breathing, and circulation to the skin. It can be completed in seconds without touching the child.
Interpretation
Abnormal appearance suggests inadequate brain perfusion or oxygenation. Increased work of breathing, such as retractions or grunting, indicates respiratory distress. Pallor, mottling, or cyanosis points to poor circulation.
Using It to Act
Combine the three components to identify respiratory distress, respiratory failure, shock, or cardiopulmonary failure. Keep the caregiver nearby to reduce anxiety, and allow the child to stay in a comfortable position when possible.