How To Take a Paediatrics History

Summary

يناقش النص المقدم قصة طب الأطفال التي تغطي مرضى من الولادة حتى المراهقة، تتراوح أعمارهم من صفر إلى 16 عامًا. يوفر النص تعليمات حول كيفية أخذ السجل الطبي للأطفال، ويشدد على أهمية التعرف على أعمار الأطفال وفهم تطورهم و antenatal history، كما أن التنمية العقلية والجسدية، وال antecedents الطبية واللقاحات، وال出身 العائلة، وال antecedents الاجتماعيين، ومراجعة أنظمة الجسم. يحتوي النص على نصائح مفيدة لكيفية تفاعل مع الأطفال ووالديهم بشكل إيجابي.

Takeaways

• 👶儿科患者年龄范围从新生儿到青少年，即0至16岁。
• 📝儿科病史的获取可能对不熟悉儿童工作的医生来说具有挑战性。
• 👨‍⚕️Dr. Erwin分享了提高生活幸福感和成功的高效习惯。
• 🔔订阅并开启通知，以获取关于幸福和成功的新视频。
• 📚儿科病史包括特定的元素，这些在传统医学病史中不常见。
• 👶儿科术语包括新生儿、婴儿、学步儿、学龄前儿童、学龄儿童和青少年。
• 🤝与儿童交流时，要表现出同理心、友好和参与感。
• 🗣️儿科病史的采集需要从儿童和家长那里获取完整的问题描述。
• 👀儿科常见症状包括发热、呼吸困难、皮疹、流鼻涕、喉咙痛、疼痛和癫痫发作。
• 🍼儿科病史中，喂养史、出生史、发育史、生长史、免疫史和家族史是关键部分。
• 🏠社会史可以提供关于儿童生活环境和条件的指示，包括家庭、学校和社交活动。
• 🧬系统回顾确保在儿科病史中没有遗漏任何重要信息。

Q & A

ما هي الفئة العمرية التي تغطيها علم الأطفال؟

علم الأطفال يغطي المرضى من الولادة حتى المراهقة، تتراوح أعمارهم من صفر إلى 16 عامًا.

لماذا يمكن أن تكون أخذ السجل الطبية للأطفال مزعجة في بعض الأحيان؟

قد تكون أخذ السجل الطبية للأطفال مزعجة إذا لم تعتاد على العمل مع الأطفال، حيث يمكن أن يكون التعامل معهم يتطلب مهارات خاصة.

ما هي الأهمية الأساسية في تحديد سن المريض في السجل الطبية للأطفال؟

تحديد سن المريض أمر أساسي في السجل الطبية للأطفال، حيث يساعد في فهم التشخيصات المحتملة والأدوية التي يمكن إدارتها.

كيف يمكن تصنيف الأطفال بناءً على سنهم في علم الأطفال؟

الأطفال يمكن تصنيفهم على أساس سنهم مثل النويون (أقل من 28 يومًا)، الرضع (بين 1 و 12 شهرًا)، الأطفال الصغيرين (بين 1 و 3 سنوات)، الطفولة المبكرة (بين 3 و 5 سنوات)، الأطفال في سن المدرسة (بين 5 و 12 سنوات)، والمراهقين (بين 13 و 17 عامًا).

لماذا يجب أن تكون الشخصية الطبية متعاطفة مع الوالدين عندما يحضرون بطفل مريض؟

قد يكون الوالدين مزعجين عندما يحضرون بطفلهم المريض، لذا يجب على الشخصية الطبية أن تكون متعاطفة وتعمل على تسهيل التفاعل مع العائلة.

ما هي الخطوات التي يجب اتباعها عند أخذ السجل الطبية للأطفال؟

الخطوات تشمل التعريف بنفسك، الحصول على الموافقة لأخذ السجل الطبية، طرح سؤال مفتوح للتعرف على السبب الذي أحضره الوالدين ب الطفل، واستكشاف السجل الطبية للشكوى الحاضرة.

كيف يمكن معرفة التاريخ الطبية للطفل إذا كان يعاني من أعراض مثل الحرارة والجفاف؟

يتطلب معرفة تاريخ الحرارة مثل متى بدأت الحرارة، ما المدة التي كانت تستمر، ومدى ارتفاع درجة الحرارة، وكذلك التحقق مما إذا كان الدواء الذي يتناوله يساعد في خفض الحرارة.

ما هي الأهمية الأساسية في التحقق من أعراض الإصابة في الأطفال؟

التحقق من أعراض الإصابة مثل الحرارة والجفاف يساعد في تحديد التشخيصات المحتملة مثل الأمراض الfebrile مثل خざي ديزاس.

لماذا يجب التحقق من تاريخ الرضاعة في الأطفال؟

التحقق من تاريخ الرضاعة يساعد في تحديد العوامل التي قد تؤدي إلى الإصابة مثل التعرض للعدوى أو الأمراض المنقولة.

ما هي الأهمية الأساسية في معرفة تاريخ الولادة للطفل عند أخذ السجل الطبية؟

تاريخ الولادة يوفر معلومات عن الوضع الصحي للطفل قبل وخلال وبعد الولادة، مما يمكن أن يساعد في التعرف على المشاكل المحتملة والتشخيص المبكر.

كيف يمكن معرفة التطورات الطبيعية للطفل من خلال السجل الطبية؟

من خلال سؤال الوالدين عن التطورات الرئيسية مثل الضحك و الوقوف والتحدث والمشي، يمكن معرفة ما إذا كان الطفل يحقق المراحل الطبيعية على النحو المتوقع.

Outlines

00:00

👶 Pediatric History and Patient Interaction

Dr. Erwin introduces the complexities of taking pediatric history, emphasizing the importance of understanding the developmental stages of children from neonates to adolescents. He highlights the need for empathy and effective communication with both the child and the parent or carer. The summary covers the significance of identifying the child's age for accurate diagnosis, the process of gathering history, and the necessity of maintaining the child's autonomy, especially with teenagers. It also touches on the unique elements of pediatric history, such as the child's resilience and the potential for rapid health deterioration.

05:01

🤒 Common Pediatric Symptoms and Their History

This paragraph delves into the common symptoms seen in pediatrics, such as fever, rash, and seizures, and the importance of understanding their progression and any contributing factors. It discusses the necessity of inquiring about the child's contact with similar illnesses, travel history, and school attendance to identify potential outbreaks or serious infections. The summary also covers the importance of a detailed feeding history, birth history, developmental milestones, and the impact of parental concerns on the diagnosis process.

10:02

🏠 Comprehensive Pediatric Assessment

The final paragraph provides a comprehensive overview of the various aspects of pediatric history, including growth history, past medical history, vaccinations, drug and allergy assessments, family history, and social history. It also discusses the importance of a systems review to ensure no symptoms are overlooked. The summary emphasizes the need for a thorough understanding of the child's environment, family medical history, and potential social factors that could affect their health.

Keywords

💡pediatría

La pediatría es la especialidad médica que se ocupa del cuidado y la promoción de la salud de los niños desde el nacimiento hasta la adolescencia, que se define como los niños de cero a 16 años de edad. En el video, se discute cómo tomar un historial pediatrico, destacando su importancia y las diferencias con un historial médico tradicional.

💡historial pediatrico

El historial pediatrico es el proceso de recolección de información sobre el paciente pediatrico, que puede ser desafiante debido a la necesidad de adaptarse al comportamiento y la comunicación del niño. El video enfatiza la importancia de ser empático y de involucrar tanto al niño como al cuidador en la recolección de esta información.

💡compensación y deterioro

El término 'compensación y deterioro' se refiere a la capacidad de los niños de adaptarse y manejar su enfermedad, pero también a su capacidad de empeorar rápidamente si no se maneja adecuadamente. El video menciona que, a pesar de la resiliencia de los niños, es crucial identificar rápidamente cualquier cambio en su estado de salud.

💡nomenclatura pediatrica

La 'nomenclatura pediatrica' es el conjunto de términos utilizados para describir las diferentes etapas de la vida de un niño, como neonato, lactante, infante, preescolar, escolar y adolescente. El video proporciona definiciones específicas de cada término y cómo se relacionan con la edad del niño.

💡compromiso

El 'compromiso' se refiere a la necesidad de involucrar tanto al niño como al cuidador en el proceso de toma de historial. El video destaca la importancia de la comunicación y cómo el compromiso de ambos partes es esencial para una historial pediatrico completo y preciso.

💡síntomas pediatricos

Los 'síntomas pediatricos' son signos y señales que pueden indicar una condición de salud en un niño. El video menciona síntomas comunes como fiebre, dificultad para respirar, erupción cutánea, corrimiento nasal, dolor de garganta, dolor y convulsiones, y cómo estos deben ser explorados en detalle durante el historial.

💡historial de convivencia

El 'historial de convivencia' es una parte importante del historial pediatrico que abarca la historia prenatal, nacimiento y postnatal del niño. El video discute cómo este historial puede influir en el diagnóstico y el tratamiento de una condición de salud del niño.

💡historial de desarrollo

El 'historial de desarrollo' se refiere a la evaluación de los hitos de desarrollo de un niño y si está alcanzando estos hitos apropiadamente. El video enfatiza la importancia de conocer el desarrollo del niño para identificar posibles retrasos o problemas de desarrollo.

💡historial de crecimiento

El 'historial de crecimiento' es la evaluación del peso y la estatura del niño para asegurarse de que esté creciendo de manera normal. El video menciona herramientas como el libro rojo en el Reino Unido, que ayuda a rastrear el crecimiento del niño.

💡vacunas

Las 'vacunas' son parte crucial del historial pediatrico, ya que pueden indicar si el niño está actualizado en su calendario de vacunación y si hay alguna razón por la que no lo esté. El video destaca la importancia de preguntar sobre el historial de vacunación del niño.

💡alergias

Las 'alergias' son reacciones adversas del cuerpo a ciertos sustancias. El video discute cómo es importante identificar las alergias del niño, ya que esto puede afectar el tratamiento y la administración de medicamentos.

💡revisión sistemática

La 'revisión sistemática' es el proceso de evaluación de los diferentes sistemas del cuerpo del niño para identificar problemas de salud no inmediatamente aparentes. El video menciona que esta revisión puede realizarse al final del historial o después de la descripción de los síntomas iniciales.

Highlights

Paediatrics covers a wide age range from neonates to adolescents, from 0 to 16 years old.

Taking a pediatric history can be challenging, especially for those not accustomed to working with children.

Dr. Erwin introduces high-performance grade habits for leading a happy and successful life.

The importance of identifying the age of a child in pediatric history and the nomenclature for different age groups.

Children can decompensate rapidly when ill, emphasizing the need for prompt and accurate diagnosis.

The necessity of being empathetic and friendly when taking a history from a young child.

Engaging with children early on is crucial for gathering an accurate pediatric history.

The pediatric history includes specific elements not generally explored in a traditional medical history.

The importance of introducing oneself and gaining permission to take a history from a child and parent.

Starting with an open question to establish the reason for the child's visit is a key step in taking a pediatric history.

Common symptoms in pediatrics include fever, breathlessness, rash, corozal symptoms, pain, and seizures.

Identifying aggravating and relieving factors for symptoms is crucial for diagnosis in pediatrics.

Feeding history is essential in pediatrics, including details on breastfeeding, bottle-feeding, and dietary intake.

Assessing bowel habits and patterns of urination and defecation are vital in pediatric history.

Gathering parental concerns and expectations is an important part of the pediatric history.

Birth history, including antenatal, natal, and postnatal details, is crucial for understanding a child's health.

Developmental history helps identify if a child is meeting developmental milestones on time.

Growth history, including weight gain and height, is an important aspect of the pediatric history.

Past medical history, including hospital visits and chronic conditions, is essential for a comprehensive pediatric history.

Vaccination history and any allergies should be assessed during the pediatric history.

Family history can reveal genetic predispositions and familial medical conditions.

Social history provides insight into the child's environment and living conditions.

Systematic review in pediatrics ensures that all potential health issues are considered.

Key elements of pediatric history include feeding, birth, developmental, growth, immunization, and family history.

Transcripts

paediatrics include patients from

neonate to adolescent ranging from the

age of zero to 16 years old taking a

pediatric history can be daunting if

you're not accustomed to working with

children if you need this channel hi my

name is dr. Erwin I have high

performance grade habits to lead a happy

and successful life I publish new video

every first day on the subject of

happiness and success if you don't want

to miss any future video don't forget to

subscribe and ring the bell today we're

going to look at the ethnic history

children are resilient and tend to

compensate when they are ill however

they can decompensate and deteriorate

rapidly identifying the age of a child

is key in pediatric history let's take a

look at the nomenclature a new net is a

child aged under 28 days an infant is a

child aged between 1 and 12 months a

toddler is a child aged between 1 and 3

years old a preschooler is a young child

aged 3 to 5 years old a child of school

age is between 5 to 12 years old and

lastly an adolescent is between the age

of 13 to 17 years old

also known as teenagers the child is

generally accompanied by a parent or

carer in very young children who do not

speak the history is taken through the

parent it is important to be aware that

parent with a sick young child might be

anxious when you take a history be

empathetic in older children the history

can be taken directly from them some

children are shy and might be

embarrassed to talk it's important to be

friendly and engage with your child

early on children like to play do not

ignore the child and talk on Isabel

perón greet the child be playful if

appropriate interact with the child and

address your questions your child with

your patient remember the child is your

patient and not the parent communication

is key to gather a good pediatric

history the child might not be able to

answer all your questions so you could

encourage the parent to pitch in the

history it is vital to get the full

account of a problem from both the child

and the parent if possible with all the

teenagers

maintaining autonomy without offending

the parent can be tricky sometimes

teenagers might feel uncomfortable

to share personal information if the

Penguins are in the room it might be

necessary to invite parent to leave to

achieve privacy the teenager might be

more at ease to answer a personal

question about sexual behavior smoking

or alcohol the pediatric history

consists of specific elements not

generally explored in a traditional

medical history first things first you

need to introduce yourself and gain

permission to take a history from a

child and parent as appropriate if your

patient is a newborn you might want to

congratulate the parents before you jump

in the history start with an open

question to establish the reason or

reasons why the parent brought the child

can you think of any question you would

ask to start the conversation you might

say what bring you today how can I help

make sure that you know who is

accompanying the patient you might also

child who's with you today the parent or

the patient might start telling you

about the presenting complaint the

symptom abroad the patient in the next

step is to explore the history of

presenting complain your aim is to get a

chronological order of how the symptoms

started how its develop and what there's

been change so you might want to ask

Wendy the problem start how did they

develop has it change common symptoms in

pediatric include fever breathlessness

rash Corozal symptoms runny nose and

sore throat pain and seizure it's

important to identify any aggravating

factors or relieving factors always ask

whether there's been any previous

episodes or similar illness let's go for

some examples let's say you have a child

who is two years old presenting with

fever and rash what do you want to know

you want to know when did the fever

start

how long has a fever been going how high

has a temperature be parents tend to

measure temperature at home and the

value the temperature was thirty-eight

point five if it represents will feed

for five consecutive days it's important

that you think about Kawasaki disease we

favor you need to ask whether the

patient has been taking any couple

paracetamol for children if the couple

has been helping with lowering the

temperature

you want to know the focus of fever

could it be an infection could it be an

upper respiratory tract infection a

urinary tract infection so you need to

be asking questions to help you make a

diagnosis Russia is common in children

with the rush you need to know how long

has it been going on whether the rash

has spread whether the child has any

allergies any recent change in fabrics

or lotion some parents may have

performed the glass tests were they

press on the skin to check whether the

rash disappears or not if the rash

doesn't fade when you apply pressure it

is in numb blanching rash an unrelenting

rash can be a sign of something more

serious infection is a common reason why

children become sick it is important to

inquire whether the patient has been in

contact with anybody with similar

illness or any of the siblings who have

been sick recently also check whether

there has been any recent overseas

travel has a child been kept from going

to nursery or school sometimes that can

be an outbreak at the nursery or school

some children may present with seizure

this presentation is frightening for

parents specially if it's the first time

it's important that you understand the

history and take a history of the

seizure procedure during the seizure and

precision make sure you assess for

meningitis or encephalitis which are

both life-threatening conditions feeding

history is important in Pediatrics you

want to know the intake of food or feet

whether the child is bottle-fed or

breastfed whether the child is taking

over fluid if the child is being

bottle-fed is it formula which one is it

how much is charming fat how frequently

if a child is feeling less than 50% or

the usual feet then you might want to

know whether there is anything else

going on if H is feeding then you would

expect the child to pass urine and to

poo you need to ask question about

whether the child has wet nappies and

dirty nappies if the child is toilet

trained then you could ask whether a

child is going for we normally whether

there's any other problem when they're

passing we with bowel motion sometimes

children can become Lou

and have diarrhea or constipation so

make sure that you explore bowel habits

it is vital to get the idea concern and

expectation in a pediatric history as

you have two persons you have a patient

and the parent make sure that you ask

both of them if appropriate parental

concern in Pediatrics taken seriously

make sure that you inquire whether the

parent has any concern and that your

address they're concerned the next

section is birth history the way I

remember it is in a chronological order

starting with antenatal birth and

postnatal you want to know about the

upset with history of a mom whether

there has been any complication whether

the scan was normal

whether there's been any problem in

blood sugar control or high blood

pressure so this is what you would cover

in the antenatal part of the birth

history the next part is gestation you

need to know whether the child is

premature or full-term fat 7 to 40 weeks

is considered full-term babies what is a

birth weight normal birth weight ranges

between 2.5 to 4.5 kilogram how about

the mode of delivery was it normal

vaginal delivery was it for sap or van

toes or was it an emergency c-section

was any complication at birth did the

tripod meconium within 24 hours was any

problem will join this fever did the

child have to stay in special care baby

unit person Italy who was there any

problem establishing feed so these are

the question that you need to ask in the

birth history the next section is

developmental history this is key in

pediatric you need to know about the

development of a child whether the child

is attaining the milestone on time or

whether there's any delay in the

development the way to remember about

asking these questions is gfs s gross

motor fine motor envision speech and

hearing and social

H I normally smile by six weeks we'll

sit by nine month start speaking first

words by 18 months start walking by 18

months make sure you study the normal

development of my son this is very

important especially if you're assessing

a child

with cerebral palsy who has any problem

with a development the next section is

gruff history this is where you explore

whether the child is gaining weight and

growing normally in the UK children have

a red book on their bone and parents

will carry this red book at consultation

so you can have a look in the red book

whether the child is growing normally

and you can plot on that graph to see

which centre they are following next

section is past medical history you need

to know whether the child has been seen

previously in hospital in Annie or by

the GP whether the child has a medical

problem that requires regular visits to

the doctor a key element of the

pediatric history is to ask about

vaccinations whether the child has been

vaccinated and up-to-date with the

immunization if the child has not been

immunized then inquire was a reason for

that the next section is drug and

allergies you need to assess whether the

patient is taking regular medication any

over-the-counter medication Calpol

neurofen or supplements also also about

allergies whether the child has any

allergic reaction to nuts to some

medications antibiotics and if they do

have allergies then also what sort of

reaction do they get Wanda exposed to

these allergens some may have severe

reactions such as rash and swelling in

which case you need to make sure that's

documented in the notes and avoid these

allergens in family history you want to

know who is living with the child at

home whether there are any siblings

whether there's any medical conditions

that run in the family you might want to

draw a family tree social history is

important because it gives you an

indication of the environment and the

conditions in which the child is living

also about parental occupation also both

smoking stages of parents or anybody

living with a child whether the health

visitors have been involved asks whether

there has been any involvement with

social services how is the charging at

nursery or school has a child finding

school has there been any problem raised

at school is there any bullying problems

because bullying is quite common

at school and it can affect the child's

health other question you might want to

us in social history is whether a child

has any hobbies whether they enjoy doing

whether the child exposed to any pets

last but not least you need to cover the

system's review some doctors prefer to

do the systems review after the history

of presenting a plane others prefer to

do it at the end there's no right or

wrong here which other works for you

a systems review will allow you to make

sure that you don't miss anything in

particular in other systems generally

you would also Bob fever about behavior

in alefo G and in drowsiness rashes then

you would proceed by asking question for

specific systems such as called the

respiratory did the child have any cough

any noisy breathing parents might tell

you that they think the child is wheezy

AB Strider or have a croup barking cough

who was having some problem with a

breathing and the discoloration of the

skin so you need to ask this question in

the systems review following the cardio

respiratory system ask about the

gastrointestinal system whether the

child has any abdominal pain any

diarrhea constipation any vomiting any

reflux ent review is imported in

Pediatrics ask whether a child has any

so fraud any snoring

noisy breathing or in the air aches you

might also want to ask about the

genitourinary system whether the child

has any burning when they're passing we

whether there have been any problem

where they're going more frequently or

they wet in the bed last but not least

also by the neuromuscular system whether

the child has any headaches and the

abnormal movements and seizures or fits

as you can gather the pediatric history

contains a lot of sections that you

would not otherwise explore in a medical

history key elements to cover in

pediatric history include feeding

history birth history developmental

history

gruff history immunization history and

family history if you need to go back

and watch this video again to make sure

that you understand which sections that

you need to go through then go back and

watch it today I hope you find this

video useful let me know down in the

comments

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thanks so much for watching take care

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