How to do history taking in pediatrics

1. INTRODUCTION TO
PEDIATRICS AND HISTORY
TAKING

2. Pediatrics
 Branch of medicine that deals with the
care of children and adolescents
 Greek word pedo pais (a child) and
iatros (healer)

3.  Goal of Pediatrics is to enable a child
to survive, to remain healthy and
attain highest possible potential of
growth, development and intellectual
achievement

4.  Child is not a miniature adult
 Clinical manifestations of diseases
differ as do the drug dosages
 Nutrition an important aspect

5.  Various subspecialties
 Includes wide spectrum from intensive
care of sick children to home based
care

6. HISTORY TAKING IN
PEDIATRICS

7. Basic Information
 Name, Age and Sex
 Son/ daughter of
 Birth order, consanguinity
 Place of residence
 Religion
 Informant, educational level and
reliability

8. Chief Problem/Presenting
Complaint
Who is Giving the History?
 Listen to the mother
 What are her worries?
 What does she think is the problem?
 Ask her to define her terms
 Quote verbatim what she says
 Understand her idioms

9. Presenting Complaint & History of
Presenting Complaint
 Presenting Complaint
use patient’s/parents own words
 History of Presenting Complaint, what was the
first thing you noticed wrong?
 When was he last well
 Mode of onset
 Course of events
 Details of treatment received

10.  Fever: Onset, duration,
documentation, character, chills and
rigors, associated localizing
symptoms.
 Cough: duration, frequency,
character, dry or productive, diurnal or
postural variation, noisy breathing
 Diarrhea
 Pain abdomen

11. History of past illness
 Any significant history
 Previous hospitalization
 Similar episodes
 Specific enquiries pertinent to present
illness
 Drug allergy

12. Family History
 Birth order, siblings
 Age of parents, how long married
 Family members, Similar illness
 Consanguinity
 Pedigree Chart
 Allergic disorders
 History of contact
 Smoking/ Alcoholism

13. Example
What does a pedigree chart look like?

14. Perinatal History
 Antenatal
 Birth history
 Postnatal

15. Developmental History
Milestones
 Gross motor
 Fine motor
 Language
 Personal social
Any delay or regression
School performance, peer interaction

16. Immunization History
 Primary vaccination
 Additional vaccines

17. Socioeconomic History
 Occupation, education and income of
parents
 No. of members, nuclear or joint family
 Kuppuswamy scale
 Water supply
 Sanitation
 Any pets at home

18. Summarize
 Chief complaints in chronological
order
 Pertinent negative history in support of
diagnosis
 Important associated history
 Nutritional status
 Identify system(s) involved

19. Key Home Messages
 Pediatric history taking is a skill
 Listen to the mother/ child
 Be sympathetic, polite and concerned
 Observe the child and establish a
rapport

21. Feeding History
 Caloric and protein intake and deficit
 Traditional practices, prelacteals
 Duration of breast feeding
 Top feeding, dilution
 Complimentary feeding
 Dietary intake before and during
illness