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#ir #peds
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
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Peds Hx
ls accompanying the patient and their relationship to patient • Previously healthy or any known major diagnoses Chief Complaint (CC)/Reason for Referral (RFR) • In patient’s or parent’s words (include duration of symptoms) <span>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 Past Medical History (PMHx) • Significant past or ongoing medical problems including: o Acute illnesses requiring ER visits, antibiotics, hospitalization o Chronic i


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