Pediatrics Exam
EM Clerkship
Zack Olson, MD ; Mike Estephan, MD ; Maddie Watts, MD
4.9 • 816 Ratings
🗓️ 26 November 2017
⏱️ 7 minutes
🧾️ Download transcript
Summary
Mnemonic: ABCDEF
Appearance
* The ‘A’ in the pediatric assessment triangle* Interactive vs distant* Good tone vs floppy* Calm and happy vs inconsolable
Breathing
* The ‘B’ in the pediatric assessment triangle* Signs of respiratory distress* Nasal flaring* Retractions* Abnormal respiratory sounds
Color/Circulation
* The ‘C’ in the pediatric assessment triangle* Pink = good* Abnormalities* Pallor* Cyanosis* Mottling
Distraction
* Almost impossible to do a good peds exam in a crying kid* Easiest ways to keep kids distracted* Let parents hold/play with them* Toys* Stethoscope* Funny sounds/noises
ENT
* Many times the kids don’t localize the symptoms* May present with vomiting, fever, irritability, etc* If difficulty examining pharynx, consider triggering a gag reflex
Fully Undress
* Look for bruising, rash, blisters* Signs of non-accidental trauma* GU exam (especially in boys, check the testes!)
Additional Reading
* Peds Respiratory Disorders (EM Clerkship)* Pediatric Assessment Triangle (Wikipedia)
Transcript
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| 0:00.0 | Hello, med students. My name is Zach Olson and thank you for downloading this week's |
| 0:07.0 | episode of the EM Clerkship Podcast. |
| 0:12.2 | This week is a quick follow-up to last week's episode on the general approach to the pediatric |
| 0:18.8 | patient. Last week, we discussed how we need to be asking about peeing, intaking, sleeping, and |
| 0:26.0 | stooling, the pre-perry and post-birth peeds history, immunization status, taking a careful |
| 0:34.0 | look at those pediatric vitals, and then as step five, I briefly mentioned |
| 0:38.7 | the ABC-D-E-F-P's exam. |
| 0:44.1 | We're going to elaborate on that exam today. |
| 0:47.5 | Sick, not sick, whatever. |
| 0:48.8 | This is the same core, fundamental physical exam that you do every time on kids. And I promise that it won't let you |
| 0:57.2 | down. It's a great physical exam template to use. A quick overview. A stands for appearance. B stands for |
| 1:05.3 | breathing. C stands for color. D stands for distract, E stands for E and F stands for fully undress and |
| 1:16.2 | examine everything. |
| 1:19.2 | We're going to start from the top and go into detail on each one of these. |
| 1:23.4 | This is the ABCDEF P's exam. |
| 1:29.3 | Let's start with A, appearance. |
| 1:36.1 | These first three steps, A, B, and C, all comprised what is called the pediatric assessment triangle. |
| 1:38.1 | I've briefly mentioned this before. |
| 1:40.6 | The sick versus not sick assessment. |
| 1:43.0 | And A stands for appearance. |
| 1:46.8 | What you do, right when you walk into the room you look at that kid and what you want to see is good strong tone alert and calm that's appearance it's a |
| 1:54.5 | general feeling what you don't want to see is the opposite floppy and weak non-, non-interactive, and really irritable. That's bad pediatric |
... |
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