Day 4 Clinical Examination Flashcards
HELP- whats it stand for
Hello: intro, consent
Engage: stethoscope, make a game, mobiles, books, toys
L: get down to their level
P:atter: don’t stay silent, explain & compliment
Where to examine
infant
toddler
child
infant: cot
toddler: on parents lap
child: bed
Peripheral CPR ↑
What to do
normal, early sign of shock
Test central
On the PAWS chart why does a child only score of temp at 39?
Children have more fevers (viral infections)
Temperature can be higher than in adults
clubbing
hypoxia
chronic anaemia
malignancies
What is ‘normal’ BP estimate dependant on?
- Age
- Height
Paediatric bp charts
Signs infective endocarditis
- Janeaway lesions
- Osler nodes
Where best to feel for pulse
- newborn
- baby
- femoral (coarctation of aorta)
- ## brachial
Where best to feel for pulse
- newborn
- baby
- older
- femoral (coarctation of aorta)
- brachial
- carotid
Auscultation
what are you listening for?
- Lungs bases (pulmonary oedema)
Murmurs
- Site
- systolic/diastolic
- grade /intensity
- pitch (high/low)
- radiation
- change with inspiration/posture
Descibe murmurs you can hear in aortic (UR), pulmonary (UL), Tricuspid (LR) and Mitral (LL)
A
- Aortic stenosis
P
- Pulmonary flow mumor
- Pulmonary stenosis
- PDA (Patent ductus arteriosis)
- ASD (atrial septic defect, downs)
T
- VSD
- Aortic regurgitation
- Still’s (innocent flow murmur)
- tricuspid regurg (rare)
M
- Mitral regurgitation (rare)
- Mitral stenosis (rare)
Grade 4 murmur
Got a thrill
Respiratory exam:
what causes grunt
preventing ↓ pressure on expiration, compensation for resp distress seen in early life.
PEP
Stridor & tracheal tug & abdominal rising
upper airway obstruction
- croup (viral)
- epiglottitis
- Severe tonsillitis
- congenital
Seesaw breathing
Intercostal reccession
Severe asthma?
