Paediatric Cardiovascular 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 (breathing, scars, sounds, dysmorphic features of Downs, Turners and Marfans)	0	1
Feels hands for temperature changes, cyanosis, capillary refill time	0	1
Checks hands for nail clubbing, splinter haemorrhages, Janeway lesions and Osler nodes	0	1
Feels radial pulse and comments on rate & rhythm	0	1
Asks to feel for brachial-brachial and radiofemoral delay	0	1
Asks for blood pressure	0	1
Feels carotid pulse, comments on volume & character	0	1
Checks for water hammer pulse	0	1
Inspects eyes for conjunctival pallor	0	1
Inspects mouth for central cyanosis, high arched palate	0	1
Assesses and comments on JVP	0	1
Palpates apex beat	0	1
Palpates for heaves & thrills	0	1
Auscultates over mitral area on expiration leaning on left. Listens for radiation in axillary area	0	1
Auscultates over tricuspid area with patient leaning forward on both inspiration and expiration	0	1
Auscultates over pulmonary area on inspiration	0	1
Auscultates over aortic area on expiration and carotid for radiation	0	1
Auscultates under left clavicle and on the back between shoulder blades	0	1
If murmur present comments on intensity, site, character, pitch, radiation	0	1
Listens over lung bases	0	1
Feels for oedema	0	1
Thanks patient and offers help to redress	0	1
Washes hands	0	1
Requests to palpate pulses, ECG, dip urine, fundoscopy	0	1
Summarises appropriately with only key findings	0	1
Offers appropriate differential diagnoses	0	1
Patient global score	0	1	2

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