Paediatric Respiratory Exam

Introduces self	0	1
Confirms name & age of patient	0	1
Explains & gains consent from parents and child	0	1
Washes hands	0	1
Exposes patient from waist up and positions at 45 degrees	0	1
Asks if patient is in pain	0	1
Asks to see red book to check growth and vaccination history. Offers to plot current height and weight	0	1
General inspection around bed & patient (comfortable, respiratory distress, pursed lips, nasal flaring, grunting, added breath sounds (wheeze, stridor, barking cough), scars, chest deformities, sputum pot, oxygen, medication)	0	1
Asks patient to take deep breath in and out to inspect symmetry of chest expansion.	0	1
Assesses hands for temperature, peripheral cyanosis, clubbing, wasting and tremor	0	1
Checks for CO2 flap	0	1
Pulse (rate, rhythm, bounding pulse) and offers to assess blood pressure	0	1
Inspects JVP in older children	0	1
Warns before assessing tracheal deviation and cricoid to suprasternal notch distance	0	1
Face for conjunctival pallor, Horner’s syndrome, tongue for central cyanosis	0	1
Palpates for apex beat	0	1
Assesses chest expansion of front	0	1
Percusses over front of chest comparing both sides	0	1
Checks tactile vocal fremitus or whisper perilolquy on front of chest	0	1
Auscultates over front of chest comparing both sides	0	1
Inspects back and assesses expansion	0	1
Percusses over back avoiding scapulae	0	1
TVF or WP on back	0	1
Auscultates back	0	1
Examines lymph nodes of neck	0	1
Checks for Sacral & ankle oedema	0	1
Thanks patient and offers help to redress	0	1
Washes hands	0	1
Requests O2 saturations, temperature, CXR, peakflow, sputum (microbiology, culture, cytology) and observations chart	0	1
Summarise appropriately with only key findings.	0	1
Offer appropriate differential diagnoses.	0	1
Patient global score	0	1	2

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