Hx taking

Question 1

What’s a good way of starting a hx for a paeds patient? [2]

Then what? [1]

Answer 1

What are the child / parent worried about?

How is it affecting the child?
- How have they been in themselves (active / playing) or lethargic / irritable?
- Are they feeding - if less, by how much? Ask fluids and solids

Then take a focused Hx

Question 2

Describe how do a detailed paeds hx [+]

Answer 2

Pregnancy:
- Problems?
- Antenatal scans?

Birth:
- Mode of delivery?
- Gestation at birth?
- Any complications?
- Birth weight?

Did they need admission to neonatal unit?

Development:
- Any concerns?
- How are they getting on at school?
- If raise concerns or theres risks about development - take full development hx

Growth:
- Weights: ask to see The Red Book (personal child health record) – used from birth to 5 years
- Puberty if older child/adolescent (on average, starts at 11 years for girls, 12 years for boys)

Feeding:
- Breast/bottle fed?
- How often / how much feed?
- Weight gain if young?
- Number of wet nappies
- Toilet training (between 2-4 years; dry by day at 2 years; dry by night at 3-4 years)
- Frequency: wet nappies? (usually ~ 5 soaking wet nappies per day and 3 yellow stools)

DH:
- Immunisations - up to date?

PMH

SH & FH
- Parents and jobs?
- Age of siblings?
- Smokers at home?
- Social worker?
- School? - what enjoy / any problems / attendance?

Finish by asking if anything missed? & ICE

NB: average birth weight: 3.3/3.4kg LBW = < 2.5 kg

Question 3

Describe what is meant by the HEADSS screening tool [+]

Answer 3