The mnemonic CIAMPEDS provides a systematic approach to triage history taking Information gathered helps the triage nurse determine potential triage interventions, isolation requirements, special needs, and triage acuity ( Table 6.5 ) Focused Physical and Pain Assessments Comprehensive physical assessment is not warranted during the triage process as it prolongs the triage evaluation and delays definitive care Once a chief complaint is determined, a focused physical assessment of the affected area(s) should be completed as abnormal findings often impact patient triage care and acuity For instance, a distended, rigid abdomen or a decreased distal pulse in an injured extremity warrants expedited physician evaluation, and therefore, higher triage acuity Pain assessment utilizing validated, developmental appropriate tools is incorporated into the triage secondary assessment to provide a baseline for the ED visit, and to assess for necessary triage intervention Vital Signs Vital signs assessment during the triage process can provide key indicators as to the severity of illness and compensatory status of the pediatric patient Table 6.6 depicts normal vital sign parameters by age as drawn from current existing literature Pediatric vital signs should be assessed utilizing appropriately sized equipment to ensure accuracy in values Blood pressure assessment should be based on nursing judgment as to patient need as it is not a critical factor in acuity assignment As fever can impact acuity for numerous pediatric populations including neonates, immunocompromised and sickle cell patients, temperature should be evaluated during the triage process Higher acuity should be considered in patients with tachycardia without fever, or tachycardia outside expected range for fever (every degree Celsius rise in temperature should correlate with a 10% rise in baseline heart rate) Pulse oximetry should be measured on patients who present with respiratory or cardiac complaints If one vital sign parameter is abnormal, it is important to obtain a full set to determine appropriate acuity assignment