History of Present Illness (HPI)
• Open‐ended question, allow parents or child to express their concerns
• Select key symptoms and expand (OPQRSTUVW+ARC):
o Onset (“When was your child last well?”), frequency, duration,
timing (intermittent vs. constant),
o Progression of illness over time (“What happened next?”)
o Quality of symptoms (description, character)
o Relieving and aggravating factors
o Severity of symptoms (quantity, visual analog scale)
o Timing and treatments sought out thus far
o U – “How is this illness affecting U?” (school, work, activities
missed)
o V – Déjà Vu: “Has this happened to you before”, similar past
episodes and treatment, outcome, complications
o What do you think is going on or what are you worried about?
o Associated Symptoms (e.g., if CC is vomiting, ask about abdominal
pain, diarrhea, fever etc.)
o Risk Factors (e.g., if CC is cough, ask about personal and family
history of asthma, eczema, atopy, allergies, exposure to smoking)
o Complications (e.g., if CC is sickle cell crisis, ask about transfusions,
chest crises, ICU admissions, major infections etc.)
• For any infectious disease symptoms always ask: recent exposures to
sick contacts (family, daycare, school), recent travel, recent antibiotic
use, animal or pet exposure
• Current hospital management: What has happened so far since you
arrived at the hospital? Treatments received, investigations, your
understanding of the plan for admission