INTRODUCTION TO THE  PEDIATRIC INTERVIEWStephanie KayPGY2 PediatricsMcMaster UniversityApril 28, 2012
OBJECTIVES   Review questions to ask on a pediatric history,    including neonates and adolescentsACKNOWLEDGEMENTS   Moh...
THINGS TO REMEMBER   Most babies don’t talk   Caregivers are right (majority of the time)   Language and culture play a...
THINGS TO REMEMBER   Lay eyes on the child first*   Focus your history in complex situations   Confidentiality
LAYING EYES ON A CHILD: SICK ORNOTSICK?   Look at their level of activity   Look at their breathing   Look at their color
BUILDING RAPPORT   Ignore young children at first   Ask non-threatening questions   Comment on t-shirt/toy   Bring toy...
HISTORY OF PRESENTING ILLNESS? Location Onset (activity at symptom onset, environment) Duration Precipitating/Palliati...
PAST MEDICAL HISTORY   Illnesses?   Surgeries?   Hospitalizations?   ER visits?
PAST MEDICAL HISTORY   Accidents/Injuries?   Immunization?   Medications?   Allergies?   *Pubertal changes*
PREGNANCY HISTORY   GTPAL   Maternal serology and blood type*   Infection, fever, antibiotics   Medications   U/S   ...
BIRTH HISTORY   Vaginal delivery vs C/S   ROM   APGAR   Birth weight   Need for oxygen, resus
NEWBORN PERIOD   Feeding   Respiratory problems   Jaundice   Stay in hospital
NUTRITION, SLEEP, AND TOILETING   Breast fed or not?       How long?   Present intake       G-tube?   # of meals, # o...
BEHAVIOUR & DEVELOPMENTMore than one setting…   Cognitive/Language       Television/Computer/Videogaming   Adaptive Ski...
FAMILY & SOCIAL HISTORY   Parents (ages/occupations/medical conditions)   Consanguinity?   Siblings (ages/medical condi...
HEADDSSS INTERVIEW INADOLESCENTS H=home E=education A=activity D=drugs D=disordered eating S=safety S=sexual activi...
REVIEW OF SYSTEMS   Head   Toe   Constitutional symptoms
CLINICAL PEARLS   Which hand do you pick your nose with?   ADHD: how long can you focus on something you    like that do...
THANKS!stephanie.kay@medportal.ca
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History Taking - Peds Day Lecture

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History Taking - Peds Day Lecture

  1. 1. INTRODUCTION TO THE PEDIATRIC INTERVIEWStephanie KayPGY2 PediatricsMcMaster UniversityApril 28, 2012
  2. 2. OBJECTIVES Review questions to ask on a pediatric history, including neonates and adolescentsACKNOWLEDGEMENTS Mohammed Zubairi, PGY3
  3. 3. THINGS TO REMEMBER Most babies don’t talk Caregivers are right (majority of the time) Language and culture play a role in child upbringing
  4. 4. THINGS TO REMEMBER Lay eyes on the child first* Focus your history in complex situations Confidentiality
  5. 5. LAYING EYES ON A CHILD: SICK ORNOTSICK? Look at their level of activity Look at their breathing Look at their color
  6. 6. BUILDING RAPPORT Ignore young children at first Ask non-threatening questions Comment on t-shirt/toy Bring toys/stickers Stay calm
  7. 7. HISTORY OF PRESENTING ILLNESS? Location Onset (activity at symptom onset, environment) Duration Precipitating/Palliating Quality Radiation Severity Timing Happened before? What do you think?
  8. 8. PAST MEDICAL HISTORY Illnesses? Surgeries? Hospitalizations? ER visits?
  9. 9. PAST MEDICAL HISTORY Accidents/Injuries? Immunization? Medications? Allergies? *Pubertal changes*
  10. 10. PREGNANCY HISTORY GTPAL Maternal serology and blood type* Infection, fever, antibiotics Medications U/S IVF
  11. 11. BIRTH HISTORY Vaginal delivery vs C/S ROM APGAR Birth weight Need for oxygen, resus
  12. 12. NEWBORN PERIOD Feeding Respiratory problems Jaundice Stay in hospital
  13. 13. NUTRITION, SLEEP, AND TOILETING Breast fed or not?  How long? Present intake  G-tube? # of meals, # of snacks Bed time? Anxiety? Toileting?
  14. 14. BEHAVIOUR & DEVELOPMENTMore than one setting… Cognitive/Language  Television/Computer/Videogaming Adaptive Skills/Fine Motor Gross Motor Social/Emotional/Behavioral
  15. 15. FAMILY & SOCIAL HISTORY Parents (ages/occupations/medical conditions) Consanguinity? Siblings (ages/medical conditions) Extended family? Supports? Housing? Recent travel?
  16. 16. HEADDSSS INTERVIEW INADOLESCENTS H=home E=education A=activity D=drugs D=disordered eating S=safety S=sexual activity S=suicidality*confidentiality
  17. 17. REVIEW OF SYSTEMS Head Toe Constitutional symptoms
  18. 18. CLINICAL PEARLS Which hand do you pick your nose with? ADHD: how long can you focus on something you like that doesn’t involve a screen Constipation: characterize the poop. Large logs are constipation too!
  19. 19. THANKS!stephanie.kay@medportal.ca

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