What are some of the different factors of a paediatric history ?
Who gives you the history? and how much is directly from the child
Specific to Paediatric history:
Social history slightly different
How can who is giving the history be different in a paediatric history ?
- 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
What are some of the non-specific complaints often in paeds history's ?
- Poor feeding
- Just not right
- ‘Nae awfy weel’ vs ‘Awfy nae weel’ - not feeling that great vs really ill
What are the 3 main specific points to remember to ask in a paeds histroy ?
- Gestation, mode of delivery, birth weight
- Immediate problems in neonatal period -? NICU
- Check reaching milestones – consider different spheres of devt. Including hearing and vision
- Any concerns re progress
- Check that completing schedule to plan
What are some of the questions you should cover in the social histroy of a paeds history ?
- Living arrangements
- Type of housing - damp etc?
- Parents –names/age/employment
- Smokers in household
- School/nursery/childcare arrangements
Appreciate the overview for the approach to a paeds history
- Presenting complaint
- History of presenting complaint
- Previous medical history
- Family history
- Social history
- Drug history/allergies
- Systemic enquiry
When faced with a paeds histroy which is e.g. cardiac in origin what should you not forget to do ?
You should not forget to ask the relevant questions to that system be it the usual cardio questions, resp ones etc
Appreciate the questions for systemic enquiry
•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