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PACES YEAR 5 > paediatrics_flashcards > Flashcards

paediatrics_flashcards

1
Q

Before the consultation, what key information should you check?

A

Check the child’s age to determine appropriate questions and areas to cover.

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2
Q

What should you do first when opening the consultation?

A

Wash your hands and don PPE if appropriate.

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3
Q

How should you introduce yourself?

A

Introduce yourself including your name and role.

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4
Q

What should you confirm about the child?

A

Confirm the child’s name and date of birth.

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5
Q

How can you build rapport with the child and their family?

A

Establish the names and relationships of the carers with the child. Build rapport by addressing the child when appropriate and observing how they interact with family.

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6
Q

What should you observe about the child initially?

A

Observe how the child is playing and interacting with any siblings and their parents/carers.

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7
Q

How should you address questions to the child?

A

Address questions to the child when appropriate, allowing them time to answer and not interrupting.

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8
Q

What is important when talking to parents/carers and the child separately?

A

Negotiate talking to parents/carers without the child present and talking to the child alone tactfully and considerately.

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9
Q

How should you explore the presenting complaint?

A

Use open questioning to explore the child’s presenting complaint.

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10
Q

What questions can you ask about the history of the presenting complaint?

A

When did the current problem start? Has the problem changed? Has medical attention been sought before now? Have there been similar episodes in the past? Does anything make the problem better or worse? Do you have photographic or video evidence?

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11
Q

What acronym can be used to explore pain as a presenting complaint?

A

The SOCRATES acronym: Site, Onset, Character, Radiation, Associations, Time course, Exacerbating or relieving factors, Severity.

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12
Q

What questions can be asked under the SOCRATES acronym for pain?

A

Questions for SOCRATES: Where is the pain? Did the pain come on suddenly or gradually? How would you describe the pain? Does the pain spread elsewhere? Are there other symptoms? How has the pain changed over time? Does anything make the pain worse or better? On a scale of 0-10, how severe is the pain?

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13
Q

What are the key components of exploring ideas, concerns, and expectations (ICE)?

A

Ideas: What do you think the problem is? Concerns: Is there anything worrying you? Expectations: What were you hoping I’d be able to do for you today?

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14
Q

How should you summarize the presenting complaint?

A

Summarize what the child/parents have told you about the presenting complaint to check your understanding.

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15
Q

What is signposting in the context of history taking?

A

Signposting involves stating what you have discussed so far and what you plan to discuss next.

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16
Q

What areas might you cover in a systems review?

A

Dietary intake, fluid intake, urine output, stool, vomiting, fever, rash, coryzal symptoms, cough, work of breathing, weight change, behaviour, pain.

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17
Q

What questions should be asked about the child’s past medical history?

A

Does the child have any medical conditions? Are they currently seeing a doctor or specialist regularly? Gather details about the condition, treatments, and complications.

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18
Q

What should you ask about surgical history?

A

Has the child undergone any surgery or procedures? When was it and why was it performed?

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19
Q

What should you ask about allergies?

A

Does the child have any allergies? What kind of reaction did they have?

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20
Q

What should you ask about prenatal history?

A

Were there any obstetric problems? Were any medications taken during the pregnancy?

21
Q

What should you ask about birth history?

A

Were there any concerns during delivery? What was the child’s gestation and birthweight?

22
Q

What should you ask about neonatal history?

A

Did the child require admission to a special care baby unit? For what reason?

23
Q

What should you ask about child development?

A

Is the child meeting their developmental milestones? Are there any concerns?

24
Q

What should you ask about growth history?

A

Is the child growing along an appropriate weight and height centile?

25
Q

What should you ask about immunisation history?

A

Is the child up to date with their immunisations?

26
Q

What should you ask about drug history?

A

Is the child currently prescribed medications or taking over-the-counter treatments? Document the medication name, dose, frequency, form, and route.

27
Q

What should you ask about family history?

A

Create a family tree, ask about conditions that run in the family, and if any relatives have recently experienced similar symptoms.

28
Q

What should you explore in the child’s social history?

A

Who lives with the child, the relationship status of parents/carers, type of accommodation, preferred play or leisure activities, happiness at home and school, smoking status of parents, impact of illness on the family.

29
Q

What questions should be asked if the child is under social services involvement?

A

Is social services currently involved with the care of the child? Is a child protection plan in place? Has there been past social services involvement?

30
Q

What does the HEEADSSS acronym stand for when taking history from an adolescent or young adult?

A

Home, Education and employment, Eating, Activities and hobbies, Drugs, alcohol, and tobacco, Sex and relationships, Self-harm, depression, and self-image, Safety and abuse.

31
Q

What key questions should be asked about home and relationships in the HEEADSSS framework?

A

Who lives at home with you? Do you have your own room? Who do you get on with best? Who do you turn to when you’re feeling down?

32
Q

What key questions should be asked about education and employment in the HEEADSSS framework?

A

Are you in school/college? Which year? What do you like/dislike at school? How are you doing at school? Do you have friends? Do you work?

33
Q

What key questions should be asked about eating in the HEEADSSS framework?

A

Are you worried about your weight or body shape? Have you noticed any change in your weight? Have you been on a diet?

34
Q

What key questions should be asked about activities and hobbies in the HEEADSSS framework?

A

How do you spend your spare time? What do you do to relax? What kind of physical activities do you do?

35
Q

What key questions should be asked about drugs, alcohol, and tobacco in the HEEADSSS framework?

A

Does anyone smoke at home? Have you been offered cigarettes? How many do you smoke each day? Have you tried or been offered alcohol? How much/how often? Have you tried cannabis? How much/how often? What about other drugs?

36
Q

What key questions should be asked about sex and relationships in the HEEADSSS framework?

A

Are you seeing anyone? Are they a boy or a girl? How have you handled intimate relationships? Have you had sex? What contraception do you use?

37
Q

What key questions should be asked about self-harm, depression, and self-image in the HEEADSSS framework?

A

How is life going? Are you worried about your weight? What do you do when you feel stressed? Do you feel sad and tearful? Have you felt life isn’t worth living? Do you think about hurting or killing yourself? Have you tried to harm yourself?

38
Q

What key questions should be asked about safety and abuse in the HEEADSSS framework?

A

Do you feel safe at school/home? Is anyone harming you? Is anyone making you do things you don’t want to? Have you felt unsafe online or using your phone?

39
Q

How should you close the consultation?

A

Summarize the key points, ask if there are any questions or concerns, thank the child and parents/carers, dispose of PPE appropriately, and wash your hands.

40
Q

PAEDS - OPENING THE CONSULTATION CHECKLIST

A
41
Q

PAEDS - PC

A
42
Q

PAEDS -HISTORY OF PC

A
43
Q

PAEDS - PMH

A
44
Q

PAEDS - DH

A
45
Q

PAEDS -FH

A
46
Q

PAEDS - SX

A
47
Q

PAEDS - CLOSING CONSULT

A
48
Q

PAEDS - KEY COMMUNCIATION POINTS

A

ICE

49
Q

SUMMARISE PAEDS CHECKLIST

A

Opening the consultation
1 Wash your hands and don PPE if appropriate
2 Introduce yourself including your name and role
3 Greet the child, their parents or carers and any other siblings who are present
4 Confirm the child’s name and date of birth
5 Explain that you’d like to take a history
6 Gain consent to proceed with taking a history
Presenting complaint
7 Use open questioning to explore the presenting complaint
History of presenting complaint
8 Explore the presenting complaint in more detail using a range of questions (e.g. when did it
start, how has it changed, has there been similar episodes in the past, does anything make it
better or worse etc)
9 Explore the child’s and parent’s/carer’s ideas, concerns and expectations
10 Summarise the presenting complaint
Systemic enquiry
11 Screen for relevant symptoms in other body systems
Past medical and surgical history
12 Ask if the child has any medical conditions
13 Ask if the child has undergone any relevant surgical procedures
14 Ask if the child has any allergies and if so, clarify what kind of reaction they had to the
substance
15 Explore the child’s prenatal, birth and neonatal history if relevant to the presenting complaint
16 Ask if the child is currently meeting their developmental and growth milestones if relevant
17 Ask if the child is up to date with their immunisations
Drug history
18 Ask if the child is currently taking any prescribed medications or over-the-counter remedies
Family history
19 Start by drawing a family tree or genogram which you can then annotate with key details
about the child’s family members
20 Ask if any family members or friends have recently experienced similar symptoms to those
the child is presenting with
21 Ask about conditions which appear to run in the family and clarify who has been affected
Social history
22 Clarify who lives with the child and the type of accommodation
23 Ask about the relationship status of the parents/carers
24 Ask about the child’s play or leisure activities
25 Ask if the child is happy at home and at school/nursery
26 Clarify the smoking status of the parents and others living with the child
27 Ask if the child is currently under the care of social services, subject to a child protection
plan or has previously had social services involvement
28 Use the HEEADSSS structure to further explore the social history of an adolescent or young
adult
Closing the consultation
29 Summarise the key points back to the child and parents/carers and ask if they feel anything
has been missed
30 Thank the child and parents/carers for their time
31 Dispose of PPE appropriately and wash your hands
Key communication skills
32 Active listening
33 Summarising
34 Signposting

PACES YEAR 5 (11 decks)

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