THE PHYSICAL EXAMINATION
The goals of the pediatric examination are also the same as the goals of adult
physical examinations: assessment and management of life-threatening injuries and
assessment of other injuries. The techniques vary according to the age of the child.
When a child of any age presents with acute, life-threatening illness or injury, conduct
the primary survey rapidly and with a minimum of preliminaries. Manage life-
threatening conditions as you would in an adult. Being aware of the characteristics and
differences of children in the various age groups and conducting the examination
accordingly will help make the examination less stressful for both the child and you.
The following are Included in age group differences.
a. Infant Under 6 Months Old.
Place the infant on a bed for examination.
Remove the infant's clothes so you can examine him thoroughly.
(3) Provide entertaining distractions for the infant; for example, make
cooing, pleasant noises to him. A child this age needs to be distracted when
undergoing a physical examination.
(4) Start at the feet and work upward (toe-to-head order). Small children do
not like strangers poking at their faces.
b. Child 6 Months to 24 Months of Age.
Remove the child's clothes so you can examine him thoroughly.
Examine the child while he is sitting on his mother's lap.
A child in this age range will not appreciate being taken from his mother to be
put on a bed or stretcher.
(3) Again, start examining the child at his feet and work your way upward.
You are examining him in the toe-to-head sequence.
(4) If there is time, try the distracting noises. The cooing and pleasant
noises may not work as well as these distractions did with the younger child.
c. Child 2 Years to 3 Years of Age.
A child in this age range is usually difficult to deal with.
(a) This child does not like his clothes removed.