INTRODUCTION TO THE PEDIATRIC INTERVIEWStephanie KayPGY2 PediatricsMcMaster UniversityApril 28, 2012
OBJECTIVES Review questions to ask on a pediatric history, including neonates and adolescentsACKNOWLEDGEMENTS Mohammed Zubairi, PGY3
THINGS TO REMEMBER Most babies don’t talk Caregivers are right (majority of the time) Language and culture play a role in child upbringing
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 toys/stickers Stay calm
HISTORY OF PRESENTING ILLNESS? Location Onset (activity at symptom onset, environment) Duration Precipitating/Palliating Quality Radiation Severity Timing Happened before? What do you think?
PAST MEDICAL HISTORY Illnesses? Surgeries? Hospitalizations? ER visits?
PAST MEDICAL HISTORY Accidents/Injuries? Immunization? Medications? Allergies? *Pubertal changes*
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 doesn’t involve a screen Constipation: characterize the poop. Large logs are constipation too!