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Pediatric Clinical Examination

This document outlines the key steps in performing a pediatric clinical examination. It emphasizes establishing rapport with the child and parents, frequent checks for pain, and explaining all procedures. Examinations of the cardiovascular, respiratory, abdominal, neurological, and musculoskeletal systems are described. For each body system, inspection, palpation, percussion and auscultation are addressed. Developmental milestones and common pediatric concerns like respiratory rate are also highlighted.

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Alexander Ennes
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1K views3 pages

Pediatric Clinical Examination

This document outlines the key steps in performing a pediatric clinical examination. It emphasizes establishing rapport with the child and parents, frequent checks for pain, and explaining all procedures. Examinations of the cardiovascular, respiratory, abdominal, neurological, and musculoskeletal systems are described. For each body system, inspection, palpation, percussion and auscultation are addressed. Developmental milestones and common pediatric concerns like respiratory rate are also highlighted.

Uploaded by

Alexander Ennes
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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Pediatric Clinical Examination

Key Points
 Introduce yourself to parents + children
 Ask child’s name
 Establish rapport
 Inspection, inspection, inspection
 Position child
 Ask about pain  Always before touching  Can’t ask too often
 Permission
o For 2 year olds  If you ask they’ll say no
o 11-onwards  Fill silence + “I’m going to” + Explain as you go along
 Extra equiptment around the bed
 Ask someone to distract the child with a toy
 Measurements  Growth chart
CVS
 Inspection  Whole child // Hands // Face // Chest
o Scars + Asymmetries
 Palpation  Pulses // BP // Apex // Praecordium
o Offer to do them all
o Femoral in small children
o NB  Know how to find the apex
 Tension Pneumo
o Feel the praecordium  Heave or thump in first days of life is an emergency
 Auscultation
o Murmers / Heart Sounds
o Back
 Other
o BP // Femorals // Hepatomegaly // Growth
 Like to move onto LIVER EXAM  Length, location
 Investigations
o Sa02 // ABG // ECG // CXR // Echo // Cardiac Cath
Respiratory
 Inspection
o RR
 Small child // School age child // Teenage
o NB
 Intercostal retractions // Subcostal recession // Nasal flaring // Tracheal tug
// Tripod position // Look at videos
 Have distensible chest  More exaggerated movements
o Color
o Nasal flaring, recession
o Stridor, Wheeze
o Hands / Face / Tracheal tug
o Chest / Extras
 Palpation
o Lymphadenopathy  Mention that you’d examine them
o Tracheal position / Apex
o Chest expansion
 Percussion
o Not in a small child
o “I’m going to see if you sound like a drum”
o Compare both sides
o Liver  Upper border 6th ICS
 Auscultation
o I am going to listen to your tummy
o Examine yourself or inanimate object
o Breath sounds  Vesicular / Bronchial
 Tactile vocal fremitus in CF  Examine
o Added sounds
 Other
o Liver // PEFR // Sputum // Growth // Ent
 Tonsils  Sleep apnea
Abdominal Exam
 Inspection  Nipples to knees
o General // Head // Face // Mouth
o If there’s a nappy  Look in it
o Abdomen = 5Fs  Flatus, Fat, Faeces, Fluid, Fetus
o Scars // Visible organomegaly // Hernia
o Genetalia // Hydrocele
 Undescended testis
o IBD  Look at anus
 Palpation
o Neck
o Abdomen  Watch childs face
 Liver / Spleen / Kidneys  know locations // how to differentiate
 Percussion
 Auscultation
 Other
Neurological
 Deep tendon reflexes  Distraction
 Tone
o Power  Levels
 Primitive reflexes
o Ask about doing Babinski
 Visual fields
 Cranial Nerves

Musculoskeletal
 pGALS
 Screen on website

Know Development

NB
- Apex
- RR
- Development

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