History Taking Paediatrics

Question 1

Adolescents when to ask parent to leave

Answer 1

Can ask parent to leave
- safeguarding
- deliberate self harm
Overdose: introduction, can I talk to x on own, then see you both together.

Question 2

What to cover in intro

Answer 2

introduction: child & parent
adolescent: ask parent to leave circumstance?
ICE of parents: concerns e.g. headache, Hx of brain tumour.

Question 3

What to write in notes

Answer 3

Date, time place (clinic/ward)
Child: name, age of child, sex, consultant
Accompanying adult(s), who’s giving Hx

Question 4

Starting PC

Answer 4

Open question, where they have come from.

Question 5

Hx PC

Answer 5

OPERATES
Onset,
Progress, 
Exacerbating factors
Relieving factors
Associated symptoms 
Timing 
Previous episodes
Severity 

Asthma: wheeze activity, night time cough 
How often using Tx: inhaler (>2 a week)
Oral prednisone, IV therapy, ICU
Tiggers
Time off school 

Fhx: atopy

Question 6

PmHx

Answer 6

Previous hospital admissions
Birth Hx:
- Gestational age: preterm, term, post term
- Birth weight 
- Birth complication
- Antenatal/postnatal problems 
- Neonatal problems (jaundice, SCBU, ventilation, antibiotics)
- Mental Health
- Feeding/weening 

Sepsis

• PROM >18 hours
• Group B strep any children (positive swabs in pregnancy)
• Maternal fever 38.5C

Delivery technique:
Vaginal: breech (shoulder, hips), instrumental (injury, cephalohaematoma (jaundice), eras palsy
CS:

Question 7

3 risk factors for neonatal sepsis

Answer 7

Sepsis

• PROM >18 hours
• Group B strep any children (positive swabs in pregnancy)
• Maternal fever 38.5C

Question 8

Drug hx

Answer 8

Drugs
Allergies
Vaccinations

Question 9

Vaccinations

Answer 9

2 months: 5 in one injection, PCV, rotavirus
3 months 
4 months
12-14: MMR, PCV, Hib/MenC
14: HPV, Tetnus, diphtheria, polio

Question 10

Social Hx

Answer 10

Whos at home (family pedigree, colour in effected, consanguinity double line)

• Mother/father/sibiling
• names, age, occupation, health

Ask consanguinity: are you related, for example are you 1st or 2nd cousins.

Nursery/primary school
Health visitors
Travel
Pets
Smoking at home

Question 11

Development Hx

Answer 11

Red book
personal child health record of milestones
- smiling
- sitting unaided
- walking alone
- 3 words with meaning 
- Dry by day/night 
HC visitis
General progress @ school
feeding

• Look at birth details
• chart for minimum contacts