clinical skills

Question 1

red flags for sepsis in kids?

Answer 1

Unresponsive to social cues/ difficult to rouse
Health professional very worried
Weak, high pitched or continuous cry
Grunting respiration or apnoeic episodes SpO2 < 90%
Severe tachypnoea (see table)
Severe tachycardia (see table)/ bradycardia < 60
No wet nappies/ not passed urine in last 18 h
Non-blanching rash or mottled/ ashen/ cyanotic
Temperature < 36oC
If under 3 months, temperature > 38oC

Question 2

what are common non-specific PC for kids?

Answer 2

Fever
Vomiting
Breathlessness
Poor feeding
Just not right

Question 3

what is important to ask in Hx in paediatrics?

Answer 3

Birth/perinatal:
Gestation, mode of delivery, birth weight
Immediate problems in neonatal period -? NICU

Development:
Check reaching milestones – consider different spheres of devt. Including hearing and vision
Any concerns re progress

Immunisations:
Check that completing schedule to plan

SHx: Living arrangements
Type of housing
Parents names/age/employment
Smokers in household
School/nursery/childcare arrangements
Pets

Question 4

what structured approach should be taken regarding a paediatric Hx?

Answer 4

Presenting complaint
History of presenting complaint
Previous medical history
Birth/perinatal
Development
Family history
Social history
Drug history/allergies
Immunisations
Systemic enquiry

Question 5

what things to look for in paediatric systemic enquiry?

Answer 5

CVS – infant feeding / sweating / cyanosis / pallor / SOB
RS – runny nose / cough / wheeze / SOB / activity limitation / snoring
GI – appetite / diet / vomiting / pain / abdominal distension / bowel habit / stools / toilet training
CNS – headaches / fits / hearing / vision / weakness / rash
Urinary– pain / colour / frequency / training
MSK- limp / limb pain / joint swelling / pain

Question 6

what does HEEADSSS refer to?

Answer 6

used for Adolescent consultation

home(sleep)
education/employment
eating
activities(friends,screens)
drugs
sexuality
suicide
safety