Approach to the paediatric patient

Essentials

• 1

  Gaining rapport with the child and the confidence of the parents is the key to assessing children. Never underestimate the power of distraction and entertainment.

• 2

  A child needs to be approached according to chronological and developmental age.

• 3

  Observation is a vital diagnostic tool, which is vastly more important in children than in adult patients.

• 4

  The need for investigations is a balance between an invasive stress on a child and the potential gain of information to aid decision making.

• 5

  Back up discharge with a concrete action plan and definitive follow-up.

• 6

  It is often more important to exclude serious illnesses than make a definitive diagnosis. This may be more easily achieved with timely review.

• 7

  Addressing parental concerns is an important part of the therapeutic process. Consider the potential fears of the child and parents.

• 8

  A febrile child should be considered as potentially sick. A thorough assessment and period of observation should be considered to ensure the diagnosis is clear.

• 9

  Consult with other specialist colleagues when the diagnosis is unclear or if serious illness cannot be excluded.