History taking Flashcards
What factors in a history may be asked to determine if a child is acutely unwell?
Nutrition = oral intake/feeds
#wet nappies and dirty nappies in last 12 hours
Irritable/less responsive/decrease LOC
Change in cry?
Sleeping more than normal? Lethargic?
Rashes
Fever
What is the BINDS pneumonic for paediatric history taking?
Birth
Immunisations
Nutrition
Development
Social
What should be included in a birth history?
Pregnancy
Delivery
Gestational age
Weight
Antenatal and postnatal problems
Infections
Maternal smoking, drug use
SCBU
What should be included for nutrition in a paediatric history?
Breast or bottle fed
How long feed for or how often?
Bottle - what formula?
Any changes to routine with current problem?
Solid diet?
Started weaning? Normally around 6 months
What are the different stages of development to consider in paediatric history taking?
Gross motor
Fine motor and vision
Speech, language and hearing
Social and emotional
What is included in the social history during paediatrics?
Family
Whos at home
Parental responsibility
Parental occupations
Smoking, alcohol and drug use in the home
Social services, Health Visitor, professional input
Asolescent - HEADSS
What is included in the HEADSS assessment of an adolescent?
Home
Education
Activity
DRugs/alcohol
Sexual health
Suicidality/risks
What is unique about a respiratory exam in an infant?
Auscultate the front and the back of the baby.
What is unique about a cardiovascular exam in paediatrics?
Infant - brachial pulse
Older children - radial pulse
All = femoral pulse
What are some MSK red flags in paediatrics?
Limb preference < 18 months
Non-weight bearing
Impaired internal rotation
Warm,red joint
