Intro to Paeds history taking

Question 1

What are some of the different factors of a paediatric history ?

Answer 1

Who gives you the history? and how much is directly from the child

Non-specific complaints

Specific to Paediatric history:

• Birth/perinatal
• Development
• Immunisations

Social history slightly different

Question 2

How can who is giving the history be different in a paediatric history ?

Answer 2

• Some of the history’s you need to take in paeds can be in very young children who may not be able to speak so often histroy is taken from a 3rd party (e.g. a parent)
• Try to direct the histroy at the kid (kids as young as 3 can often contribute) where possible

Question 3

What are some of the non-specific complaints often in paeds history’s ?

Answer 3

• Fever
• Vomiting
• SOB
• Poor feeding
• Just not right
• ‘Nae awfy weel’ vs ‘Awfy nae weel’ - not feeling that great vs really ill

Question 4

What are the 3 main specific points to remember to ask in a paeds histroy ?

Answer 4

Birth/perinatal

• Gestation, mode of delivery, birth weight
• Immediate problems in neonatal period -? NICU

Development

• Check reaching milestones – consider different spheres of devt. Including hearing and vision
• Any concerns re progress

Immunisations

• Check that completing schedule to plan

Question 5

What are some of the questions you should cover in the social histroy of a paeds history ?

Answer 5

• Living arrangements
• Type of housing - damp etc?
• Parents –names/age/employment
• Smokers in household
• School/nursery/childcare arrangements
• Pets

Question 6

Appreciate the overview for the approach to a paeds history

Answer 6

• Presenting complaint
• History of presenting complaint
• Previous medical history
• Birth/perinatal
• Development
• Family history
• Social history
• Drug history/allergies
• Immunisations
• Systemic enquiry

Question 7

When faced with a paeds histroy which is e.g. cardiac in origin what should you not forget to do ?

Answer 7

You should not forget to ask the relevant questions to that system be it the usual cardio questions, resp ones etc

Question 8

Appreciate the questions for systemic enquiry

Answer 8

• CVS – infant feeding / sweating / cyanosis / pallor / SOB
• RS – runny nose / cough / wheeze / SOB / activity limitation / snoring
• GI – appetite / diet / vomiting / pain / abdominal distension / bowel habit / stools / toilet training
• CNS – headaches / fits / hearing / vision / weakness / rash
• Urinary – pain / colour / frequency / training
• MSK - limp / limb pain / joint swelling / pain