Pediatrics
Presentations, by age
Presentation-first, the way children arrive: what you are worried about, the differential by age band, the history and examination that discriminate, the red flags, the investigations and how to read them, and what to do when the child is deteriorating.
Fever
The commonest reason a child is brought in, and the one where age rewrites the workup.
6 age bands · 6 red flags
Cough and respiratory distress
Bronchiolitis, croup, asthma and pneumonia are separated by the age, the sound and the effort, not by the X-ray.
6 age bands · 6 red flags
Vomiting
A symptom of the whole child: obstruction in the newborn, intussusception in the infant, the head and the ketones in the older child.
6 age bands · 6 red flags
Diarrhea and dehydration
The assessment is clinical, the treatment is usually oral, and the weight is the best measurement in the building.
5 age bands · 6 red flags
Abdominal pain
Young children localize poorly; the age tells you where to look, and the examination is done by watching the face.
5 age bands · 5 red flags
Seizure
Was it a seizure, was it the first, was there a fever, and what age is the child: four questions that carry most of the decision.
6 age bands · 6 red flags
Limp
The hip diagnoses are stacked by age, and the child who will not weight-bear with a fever is septic until proven otherwise.
5 age bands · 5 red flags
Rash with fever
Is the child well or unwell, does the rash blanch, and where did it start: the morphology is DermSpace's, the sick child is ours.
5 age bands · 5 red flags
Jaundice
In the newborn a bilirubin-and-time question with a treatment threshold; after two weeks, the fraction that matters is the conjugated one.
5 age bands · 5 red flags
Poor weight gain
Faltering growth is a trajectory, not a point; most of it is intake, and the history of a feed tells you more than the blood tests.
6 age bands · 5 red flags
Altered level of consciousness
The drowsy child is the emergency that is easiest to miss because the child is quiet.
6 age bands · 5 red flags
Newborn fever
Under 28 days the examination cannot exclude serious infection, so the workup is complete and the treatment is empiric.
1 age bands · 4 red flags
Stridor
Inspiratory noise means the obstruction is above the chest; the question is how much airway is left and how fast it is closing.
6 age bands · 5 red flags