1. Paediatric Hx and Exam Flashcards
At what age can a child normally give an account of their illness?
Around age 5, so involve them in the consultation.
List the headings of the paediatric history?
- History of the Presenting Complaint
- Previous Medical History
- Medications
- Social History
- Family History
What are the objectives when establishing the history of the presenting complaint?
Establish full details of presenting symptoms
When last well?
Duration of complaint
(Take time on this, in order to enjoy detailed description of what is going on.)
What questions should be asked concerning the history of the presenting complaint?
- Who is the child?
- Where are they from?
- What is the current issue with the child?
- Why did the family come to the hospital?
- How long has the child been unwell?
- Associated Symptoms?
- Relieving and aggravating factors?
- Improving/Worsening with time?
- What have they done about it?
- Previous similar episodes?
- Family history of similar complaints
- Effect on child or family’s lifestyle
What are the subcategories listed under ‘Past Medical History’ of a paediatric patient?
- Medical
- Surgical
- Birth and Antenatal
- Nutritional
- Immunisation
- Developmental
What information regarding Birth and Antenatal History should be collected?
- Where Born
- Gestation
- Problems during pregnancy
- Birth Weight
- Delivery
- SCBU
What information regarding Nutritional History should be collected?
- Breast/Bottle feed
- Weaning
- Current Diet
What information regarding Immunisation History should be collected?
- Ask about and record EACH individual Vaccination
- Standard immunization schedule
- If not vaccinated, challenge guardians as to why
What information regarding Developmental History should be collected?
Any parental concerns?
Reaching major milestones…
-Gross Motor (siting up, unsupported, etc.)
-Fine Motor Skills (hand to midline, reaching out to toys, oral phase etc.)
-Speech and Hearing
-Social and Behavioral
What information regarding Social History should be collected?
Who lives in the house? Position in the family tree (psychological implications) Parents employment Childcare arrangements Pets Smokers? Alcohol Schooling (Class, Friends, Academic Performance)
What shoud be ensured before conducting a pediatric examination?
- Need the child on your side
- Non-threatening approach
- Explain everything and confirm the child’s assent
- Examination must be age appropriate
- Respect all children’s privacy
What should be looked for during the initial, general (paediatric) examination?
- General Appearance -Well or Unwell
- Colour
- Dysmorphic features
- Nutritional Status and Hydration
- Level of Care
- Surrounds
What should always be done during a paediatric examination?
Always: Inspect, palpate, percuss, auscultate
