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How should you diagnose and treat a pediatric emergency?
Emergency pediatric diagnosis and treatment is linked to the age of the patient. A proper evaluation can rarely be made if the child's age is not known. Get answers to questions relevant to age of patient. Is your child having an emergency? __________________________________________________________________ Where is the patient now? __________________________________________________________________ How old is the patient? __________________________________________________________________ What seems to be the problem? __________________________________________________________________ What is the reason for consultation? __________________________________________________________________ These are basic questions. There are many more. What is the child's gender? __________________________________________________________________ What is her/his name? __________________________________________________________________ Where and when was she/he born? __________________________________________________________________ How old is she/he? __________________________________________________________________ What is her/his father's name? __________________________________________________________________ What is her/his mother's name? __________________________________________________________________ Are they living? __________________________________________________________________ Where are they now? __________________________________________________________________ What is today's date? __________________________________________________________________ What is the source of this history? __________________________________________________________________ What are the sources to verify this history? __________________________________________________________________ What is the reason for consultation? __________________________________________________________________ Appearance Is there proper tone, intractability, consolabilty, look/gaze, and speech/cry (TICLS)? __________________________________________________________________ Tone Is there any movement of the extremities? __________________________________________________________________ Is he or she showing movement relevant to age? __________________________________________________________________ Is she moving around or resisting examination vigorously and spontaneously? __________________________________________________________________ Is there good muscle tone? __________________________________________________________________ Intractability How alert is the child? __________________________________________________________________ How readily does a person, object, or sound distract or draw his/her attention? __________________________________________________________________ Will he or she reach out, grasp, and play with a toy or new object, like a pen or ball? __________________________________________________________________ Consolability Can the child be consoled or comforted by the caregiver or the clinician? __________________________________________________________________ Look/Gaze Can the child fix his or her gaze on the clinician's or caregiver's face, or is there a glassy-eyed stare? __________________________________________________________________ Speech/Cry Is there any speech/cry? __________________________________________________________________ Is the child's speech/cry strong and spontaneous or weak, muffled, or hoarse? __________________________________________________________________ Neuralgic assessment Is the patient alert, responsive to verbal or painful stimuli, or unresponsive (AVPU)? __________________________________________________________________ Is the child in the caregiver's lap or arms, or in bed? __________________________________________________________________ How is the caregiver related to him or her? __________________________________________________________________ Who else lives with the child? __________________________________________________________________ How long have they lived there? __________________________________________________________________ Does the patient respond to bright light or toys? __________________________________________________________________ Does approaching the child cause agitation and crying? __________________________________________________________________ Feed When was the child fed last? __________________________________________________________________ Who prepared and fed the child last? __________________________________________________________________ When is the next feeding due? __________________________________________________________________ When was the child’s diaper last replaced? __________________________________________________________________ Breathing Are there any abnormal breath sounds like altered speech, grunting, and wheezing? __________________________________________________________________ Is there any abnormal positioning, retractions, and nasal flaring? __________________________________________________________________ In case there is no speech or crying, when and who heard the speech or cry of the child last? __________________________________________________________________ Is there any pallor, cynosis, listness? __________________________________________________________________ What is the respiratory rate? __________________________________________________________________ Is this respiratory rate normal for this age? __________________________________________________________________ What is the oxygen saturation by pulse oximetry? __________________________________________________________________ Is it normal? __________________________________________________________________ Injuries Are there any injuries? __________________________________________________________________ If yes, what are the details. __________________________________________________________________ Is there any vomiting? __________________________________________________________________ When and in what consistency was the last bowel motion? __________________________________________________________________ What are the vitals for the child? __________________________________________________________________ Are these vitals normal for this age? __________________________________________________________________ Is there any abnormality in the vitals? __________________________________________________________________ Birth details What was his or her birth weight? __________________________________________________________________ What is the normal birth weight? 1. An average birth weight is 3.5 kg 2. Infants double birth weight by five months (7.0 kg) 3. Infants triple birth weight at one year (~10kg). 4. In older children, weight in kg = 8 + (2 x age in years) In case of weight in pounds, do the relevant calculations. Was his or her birth full-term normal delivery, preterm, or post term? __________________________________________________________________ If birth was preterm or post term, what are further details? __________________________________________________________________ What is the weight as of today? __________________________________________________________________ How should the weight of babies improve? __________________________________________________________________ What is the child's height as of today? __________________________________________________________________ Is there any history of a congenital medical condition? __________________________________________________________________ Do you have any congenital medical condition? __________________________________________________________________ What is the mother's profile as of today? __________________________________________________________________ What is the father's profile as of today? __________________________________________________________________ What, how much, and how many feedings will you give to a full-term normal delivery newborn human baby? __________________________________________________________________ Emergency medico legal case Is there any conspiracy, harm, intention to cause harm, or abuse in the case scenario? __________________________________________________________________ If yes, involve police, community, state department of law, or others as soon as possible. This is a case scenario of conspiracy, harm, intention to cause harm, or abuse. Your consultation/opinion is required. Proceed for a criminal investigation. If the child does not have any caregiver, put an ankle or wrist band with emergency identification number on him/her and further details of person managing the case. What emergency diagnosis and treatment should emergency medical doctors and pediatricians know relevant to pediatrics? __________________________________________________________________ What best describes the diagnosis among the listed diagnoses? __________________________________________________________________ Emergency diagnosis and treatment in neonatal period. Emergency diagnosis and treatment after neonatal period. What is the treatment? __________________________________________________________________ Do not list an assistant surgeon on the record. List a medical doctor on the record. A medical doctor is expected to diagnose and treat all medical emergencies and all medical non-emergencies. |