2. Paeds History Taking Flashcards
What helps building rapport with kids?
Thinking about your childhood What made you happy What triggered your imagination What was fun Favourite toys Best things to play with
What can you prepare before seeing the child?
Why they are three Name, age and sex Observe child before starting your assessment Likely diagnosis If in clinic set up toys What to rule out/what is serious What have the nurses seen
What are the key stages to history taking
Establish patient name and family dynamic
Presenting complaint
HOPC
Narrow differential
What are some helpful units to know when dealing with weight?
450g is a pound
And ounce is a 1/16th of a pound
A Stone is 14 pounds (6.3Kg)
KG and grams used here
How much weight should a baby gain?
150-200g/ week 1st 6 months
20-30g per day
Up to 10% loss in first few days is common
How do you measure feed volumes
What is normal feed volumes
What is important to know about feed volumes?
Millilitres in Britain,
Babies should have around 140-180 ml/kg/day
Fluid ounces in America, around 30ml to an ounce
20 ounces in a pint
What should you ask about poo?
Children in nappies bs independent toileting Frequency (per day, week or even month) Size shape appearance and consistency Difficulty passing Pain passing Blood or mucus seem
What else is covered in a paediatric history?
Past history Immunisations Development Medications Family and social history- family dynamic, smoking
What do you ask about pregnancy is a paediatric history?
Pregnancy (Consider: Gestation/ Mode of delivery/ Place of Birth/ Birth weight/ Mother’s
antenatal health and any problems in labour/ Need for resuscitation or neonatal care after birth.
- The detail explored will depend on the age and presentation of the child- of greater
relevance if the child is an infant or presenting with a respiratory, neurological or developmental problem)
Challenges to an examination of a child?
Can’t jump straight in
Collatearal history
Dealing with parents
What tricks can you use for the general examination?
Use toys to assess movement, eyes,
Feel lymph nodes carefully from front on
Listen through clothing to avoid cold stethoscope
Resp rate and rate of breathing just be looking
What are some tips to start an examination
Observe first
Don’t blame face the child, stay happy
Speak to the child even if they are weeks old
Get down to their level
Be careful moving them, keep parents close
Gradual exposure
Show interest in toys and play
What is the method for paediatric examination?
Pre assessment Observe during history Think of each system Think of each area Think of the method for that age Rapport is essential
