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Thursday, March 25, 2010

Pediatric Respiratory Case

  1. Child is lying comfortably on the bed, looks alert, conscious, active, (pink, bluish, dusky, pale).
  2. Respiratory rate is 110 (Do not use adjective like 'about', 'lebih kurang' or 'probably'. It indicates that you are bull shitting or unsure).
  3. He/She is not in respiratory distress as there are no signs of use of accessory muscles, subcoastal or intercostal recessions, stridor/ grunting, tachypnea or nasal flaring.
  4. No clubbing, flapping tremor (asterixis).
  5. There is pectus carinatum/excavatum. (Say this if there is deformity. Skip if there is none)
  6. There is no chest deformities, scars or lesions.
  7. However chest is slightly inflated and Harrison's sulcus can be seen. (Again skip this if not relevant)
  8. Trachea is not deviated and apex beat is not displaced. (Do not say, "Apex beat is located at the 5th intercoastal space 1 cm medial to midclavicular line." That is too long. Say if only asked)
  9. Lung is resonant, and has equal air entry. (If the is any pathology, describe the pathology first.)
  10. Spine is normal.
Eg; (Asthma)
Child is lying comfortably on the bed, looks alert, conscious, active, and pink. Respiratory rate is 110. He is not in respiratory distress as there are no signs of use of accessory muscles, subcoastal or intercostal recessions, stridor/ grunting, tachypnea or nasal flaring. No clubbing, flapping tremor (asterixis). There is no chest deformities, scars or lesions. However chest is slightly inflated and Harrison's sulcus can be seen. Trachea is not deviated and apex beat is not displaced. Ronchi heard bilaterally over the lower lobes, otherwise lung is resonant and has equal air entry.

This is an example. The whole thing is supposed to be articulated in about 2 minutes. Please give some feedback. Please leave comments below.

1 comment:

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