#ir #peds
Newborn
Case 1: A 3-week-old male presented to the
emergency department for congestion and
cough. Mom stated that the infant was not
eating as well, but had normal wet diapers.
No fever noted at home or on exam.
As mentioned above, it is important to
observe the newborn. One of the best tips
is to undress and hold the baby. Holding
allows the clinician to assess multiple
things at once, including level of alertness,
respiratory status and tone. This initial
assessment gives the clinician a good
sense of “sick or not sick.”
It is also important to have the baby
undressed to do a careful examination,
looking for rashes, bruises, hair
tourniquets, etc. During the exam, this
newborn was observed to have an apneic
episode. The patient was admitted for
an evaluation that ultimately revealed a
diagnosis of pertussis.
Infant
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Tricking Kids into the Perfect Exam: Tips for Evaluating the Pediatric Patient3;
looking in the ears and mouth.
Here are a few cases to illustrate the
importance of the physical exam and
emphasize other tips for evaluating those
age groups that provide the most anxiety
and diffi cult exam.
<span>Newborn
Case 1: A 3-week-old male presented to the
emergency department for congestion and
cough. Mom stated that the infant was not
eating as well, but had normal wet diapers.
No fever noted at home or on exam.
As mentioned above, it is important to
observe the newborn. One of the best tips
is to undress and hold the baby. Holding
allows the clinician to assess multiple
things at once, including level of alertness,
respiratory status and tone. This initial
assessment gives the clinician a good
sense of “sick or not sick.”
It is also important to have the baby
undressed to do a careful examination,
looking for rashes, bruises, hair
tourniquets, etc. During the exam, this
newborn was observed to have an apneic
episode. The patient was admitted for
an evaluation that ultimately revealed a
diagnosis of pertussis.
Infant
Case 2: A 5-month-old male presented
with fever and fussiness. The patient
was seen fi ve days earlier with fever and
URI, diagnosed with otitis media and
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