Paediatrics assessment

Little people are different

• Low physiological reserve (they deteriorate quicker and there is a lower threshold for investigating, admitting or treating)
• Few co-morbidities (and return to normal function rapidly)
• Growth and development are sensitive indicators of chronic biological, psychological or social problems
• Infant immune systems aren't fully developed
• The younger ones can't verbalise their problems well (you need to rely on carers observations)
• Little ones can't look after themselves and vulnerable (NAI)
• A lot more factors can affect their health and wellbeing - parental care, social situation, nutrition

Important considerations in the assessment

Are there any birth issues that might set the child back?

• Pre-term
• Prolonged or recurrent hospitalisations
• Chronic illness

Is the child well-cared for?

• Home carers - number, occupation - PT/FT
• Social support - relatives, friends, child care
• Siblings - how many, requiring special needs

Is there good preventative care?

• Nutrition - age appropriate feeding, types of meals
• Immunizations
• Preventative care

Is the child developing normally?

• Growth charts
• Milestones

Is the child critically unwell?

• Listless or drowsy - does not recognise mum or respond to painful stimuli e.g. venipuncture
• Stridor
• Significant sternal or intercostal recession
• Poorly perfused e.g cap refill > 4sec
• Acute weight loss > 10% in one week.
• Purpuric rash