Paediatric Cardiovascular Exam

May 25, 2016 Print Friendly Version of this page Print Get a PDF version of this webpage PDF
Introduces self
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1

Confirms name & age of patient
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1

Explains & gains consent from parents and child
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1

Washes hands
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1

Exposes patient from waist up and positions at 45 degrees
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1

Asks if patient is in pain
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1

Asks to see red book to check growth and vaccination history. Offers to plot current height and weight
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1

General inspection around bed & patient (breathing, scars, sounds, dysmorphic features of Downs, Turners and Marfans)
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1

Feels hands for temperature changes, cyanosis, capillary refill time
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1

Checks hands for nail clubbing, splinter haemorrhages, Janeway lesions and Osler nodes
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1

Feels radial pulse and comments on rate & rhythm
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1

Asks to feel for brachial-brachial and radiofemoral delay
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1

Asks for blood pressure
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1

Feels carotid pulse, comments on volume & character
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1

Checks for water hammer pulse
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1

Inspects eyes for conjunctival pallor
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1

Inspects mouth for central cyanosis, high arched palate
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1

Assesses and comments on JVP
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1

Palpates apex beat
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1

Palpates for heaves & thrills
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1

Auscultates over mitral area on expiration leaning on left. Listens for radiation in axillary area
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1

Auscultates over tricuspid area with patient leaning forward on both inspiration and expiration
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1

Auscultates over pulmonary area on inspiration
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1

Auscultates over aortic area on expiration and carotid for radiation
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1

Auscultates under left clavicle and on the back between shoulder blades
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1

If murmur present comments on intensity, site, character, pitch, radiation
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1

Listens over lung bases
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1

Feels for oedema
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1

Thanks patient and offers help to redress
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1

Washes hands
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1

Requests to palpate pulses, ECG, dip urine, fundoscopy
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1

Summarises appropriately with only key findings
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1

Offers appropriate differential diagnoses
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1

Patient global score
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1
2