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Techniques of Physical Examination | Part Five

Considerations for Examining an Infant or Child:

Infants – under 1 year
Child – age 1-8 years old

Differences to keep in mind:

  • Internal organs are larger in proportion to adult, all packed in small space
  • Head is larger in proportion to body, injuries common
  • Bones are softer and more flexible, will bend, may not break
  • Nervous system is not as well developed, response to stimuli may be slower

Approach to Children: remember they may fear strangers. Enlist the parents, be patient.

Initial Evaluation:

  • Responsiveness use AVPU
  • Respiratory Status: most serious pediatric problems and cardiac arrests start with a primary respiratory event. First sign is TACHYPNEA, prevention is better than resuscitation
  • Circulatory status: slow irregular pulse is a poor sign. Evaluate skin temp, color, condition and capillary refill (may not be good indicator esp. in cold)

General Guidelines for recording examination information: all findings negative and positive need to be documented according to local protocols.

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