The Physical Examination Interview: Pediatric Examination

Pediatric examination: Cont.

Patient is lying flat with his arms on the sides. Knees can be flexed to relax the
abdomen.

1- General appearance:
For alertness, facial expressions and general affect, speech, crying and
interaction with others.
To the examiner “Patient is/is not in distress. ”
“The patient is lying relaxed/ completely still (peritonitis)/
moving in distress (colic)/ curled up in fetal position
(visceral pain)/ lying with one hip flexed (splinting).”

“ Child name ….., What is the date today? …., and Where are you now?”.
To the examiner “The patient is alert. ”

* Developmental Milestones:
Ask the parents (or watch):
To the examiner “Developmental milestones are appropriate for age as
the patient can …...(Age related NOW only). ”
Growth
* Measure Height, Weight (& Head circumference for <1 year old unless charts are
abnormally big): common in
OSCEs.
1- Plot on growth charts. It is very
2- Focus on growth trends. important
3- Pay attention to crossing of percentile. to learn to
4- Compare with parents’ size. interpret
them and
For infants measure height supine & use infant scale for weight. explain
finding to
“Let me see how tall are you?, Come stand up here let us measure the parents.
that….Good… Now, let me see how heavy are you? Come stand up on
this scale…Good... Let me see how big is you head; let me measure it
with this measuring tape? Come sit down here”
To the examiner “Height, weight (& head circumference) are
appropriate for age.”

2- Ask for Vital signs and Survey:

“What are his/her vitals, please? ”

Carefully listen/ read and comment:

To the examiner “Normal/ so, he has fever/tachycardia/ tachypnea….”.

… Continued

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