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#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 Patient
3; 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 disch


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