Paediatric examination

The examination of the child should follow roughly similar lines to examination of an adult. However, there are a number of additional features to bear in mind:

• gaining the confidence of the child with a friendly, non-threatening approach can stand the examiner in excellent stead. Elements of the examination can become a bit of a game.
• avoiding frightening the child is an important feature; this can include simple measures such as warming the stethoscope before placing it on the chest, or warning the child that you are going to make a tapping sound before percussion.
• especially in the small child the whole sequence of the examination can be altered to suit the circumstances. Thus, auscultation of a quiet infant may justifiably preceed the rest of the examination. It remains important, however, to perform a complete examination; altering the order is not an excuse for sloppiness.