7. Abnormal Signs And Symptoms
1) RR > 60 breaths/ min for a sustained period
2) Normal HR > 2-3 time of Normal RR for
particular age
3) Low BP – Neonate Systolic < 60 mm Hg.
1 month – 1 yr < 70 mm Hg.
1 yr – 10 yr < 70 + ( 2 x Age ) mm Hg
> 10 yr < 90 mm Hg
8. To Assess Airway Patency
Look for –
1) Breathing movements of the child, Chest
and Abd
2) Feel the movement of air on Mouth and Nose
3) Listen for Breath sounds
4) Abnormal breathing sounds like – Snoring or
Stridor
5) Increased work of breathing and apnea
12. Assessment of Circulation
S/o decreased perfusion and compromised CO
1) Mottling
2) Pallor
3) Increased CRT
4) Cyanosis
5) Poor Pulse
6) Cool Extremities
13. TACHYCARDIA IS EARLIEST
AND MOST RELIABLE S/0
SHOCK
But is itself fairly non-specific and
should be co-related with other
component of exam i.e. weakness,
threadiness, absense of pulse.
14. • Skin Color
• Temperature
• HR
• Heart rhythm
• Pulse
• BP
15. Disability
Refers to a child’s Neurologic Function
A) Level of Consciousness
B) Cortical Function
17. AVPU Scale
It measures the level of both, level of consciousness
and cerebral cortical function
A --------------------- Alert
V --------------------- Verbal
P --------------------- Pain Stimuli
U -------------------- Unresponsive to any stimuli
21. GCS SCALE LESS THAN OR
EQUAL TO 8 NEEDS
ELECTIVE VENTILATION
22. Exposure
It is the final component of Primary Assessment
Look for –
- Burning
- Bruising
- Joint Laxity
- Fracture
23. Secondary Assessment
S ---- Signs and Symptoms
A ---- Allergies
M ---- Medication
P ---- Past Medical History
L ---- Time of last Meal
E ---- Event leading this situation
History
28. Most Probable Diagnosis
1) Inc. Urination + Recurrent Vomiting + Inc. RBS
DIABETES MELLITUS
2) Billous Vomiting + Abd. Distension
Suggestive INTESTINAL OBSTRUCTION
3) Wheezing after cough or choking in older child
FOREIGN BODY
4) Fever + Involvement of 1 joint + Peudoparalysis
of that joint
SEPTIC JOINT
29. 5) Pain + Stiffness + Swelling + Warmth +
Involvement of Several Joints
JRA
6) Appendicitis < 3 yr, very rare.
7) Continuous Tachycardia + Poor Perfusion
MYOCARDITIS