Paediatric Respiratory Exam

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Introduces self 0 1

Confirms name & age of patient 0 1

Explains & gains consent from parents and child 0 1

Washes hands 0 1

Exposes patient from waist up and positions at 45 degrees 0 1

Asks if patient is in pain 0 1

Asks to see red book to check growth and vaccination history. Offers to 0 1
plot current height and weight

General inspection around bed & patient (comfortable, respiratory 0 1

distress, pursed lips, nasal flaring, grunting, added breath sounds
(wheeze, stridor, barking cough), scars, chest deformities, sputum pot,
oxygen, medication)

Asks patient to take deep breath in and out to inspect symmetry of chest 0 1
expansion.

Assesses hands for temperature, peripheral cyanosis, clubbing, wasting 0 1

and tremor

Checks for CO2 flap 0 1

Pulse (rate, rhythm, bounding pulse) and offers to assess blood pressure 0 1

Inspects JVP in older children 0 1

Warns before assessing tracheal deviation and cricoid to suprasternal 0 1

notch distance

Face for conjunctival pallor, Horner’s syndrome, tongue for central 0 1

cyanosis

Palpates for apex beat 0 1

Assesses chest expansion of front 0 1

Percusses over front of chest comparing both sides 0 1

Checks tactile vocal fremitus or whisper perilolquy on front of chest 0 1

Auscultates over front of chest comparing both sides 0 1

Inspects back and assesses expansion 0 1

Percusses over back avoiding scapulae 0 1

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TVF or WP on back 0 1

Auscultates back 0 1

Examines lymph nodes of neck 0 1

Checks for Sacral & ankle oedema 0 1

Thanks patient and offers help to redress 0 1

Washes hands 0 1

Requests O2 saturations, temperature, CXR, peakflow, sputum 0 1

(microbiology, culture, cytology) and observations chart

Summarise appropriately with only key findings. 0 1

Offer appropriate differential diagnoses. 0 1

Patient global score 0 1 2

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