History and examination Flashcards
What are the 3 parties involved when you take a paediatric history?
Child
Parent - knows child better than clinician
Clinician - knows more about medicine than parent
Don’t assume you know who you’re taking a history from
What presenting complaints can you get with children?
Viral infections v common Cough Rash Fever Miserable child Gen unwell
What do you need to ask about in HPC?
Feeding/hydration - how long feeding for?, volume?, nappies - wet and dirty
Fever - how checking temperature, done anything about it?
Rashes - where?
Behaviour - smiling? Laughing? Changes?
Contacts - been in contact with someone unwell? Reassures you viral infection
What do you need to ask about in PMH and birth history?
PMH same as adult - often no PMH
Born on time? How many weeks? Normal vaginal delivery? C-section? Emergency? Why?
Breast fed?
Any problems after birth? Any time on neonatal wards?
Tailor to childs age and issue
What should you ask about in a developmental history?
What are they doing? Crawling? Holding onto furniture to walk?
Any developmental issues? - probe as might not know
Height? Growth normal?
What should you ask about in drug and vaccination history?
DHx same as adults
Up to date with vaccines? Seasonal flu? Preterm - got extra vaccine?
What should you ask about in a social and family history?
Social - smoking around child, pets, school - who are they around?
Family diagrams - who are they in contact with? Everyone well?
Why are ENT examinations important?
Common site of infection
Routine examination
What should you look for in the ears?
External - Obvious ear abnormalities - Redness - Discharge - Smell Tympanic membrane
What should you look for in the throat?
Position of child Facial dysmorphism - can suggest upper airway problems Drooling Stridor Lymph nodes Tonsils!!
