TOOLS ON PHYSICAL ASSESSMENT
Inspection/Observation
Observe the overall appearance of the child: alert, orientated, active/hyperactive/drowsy, irritable.
Colour(centrally and peripherally): pink, flushed, pale, mottled, cyanosed , clubbing
Respiratory rate, rhythm and depth (shallow, normal or deep)
Respiratory effort (Work of Breathing WOB): mild, moderate, severe, inspiratory: expiratory ratio, shortness of breath
Use of accessory muscles (UOAM): intercostal/subcostal/suprasternal/supraclavicular/substernal retractions, head bob, nasal flaring
Symmetry and shape of chest
Tracheal position, tracheal tug
Audible sounds: vocalisation, wheeze, stridor, grunt, cough - productive/paroxysmal
Monitor for oxygen saturation
Auscultation
Listen for absence /equality of breath sounds
Auscultate lung fields for bilateral adventitious noises e.g.: wheeze, crackles etc
Observe the overall appearance of the child: alert, orientated, active/hyperactive/drowsy, irritable.
Colour(centrally and peripherally): pink, flushed, pale, mottled, cyanosed , clubbing
Respiratory rate, rhythm and depth (shallow, normal or deep)
Respiratory effort (Work of Breathing WOB): mild, moderate, severe, inspiratory: expiratory ratio, shortness of breath
Use of accessory muscles (UOAM): intercostal/subcostal/suprasternal/supraclavicular/substernal retractions, head bob, nasal flaring
Symmetry and shape of chest
Tracheal position, tracheal tug
Audible sounds: vocalisation, wheeze, stridor, grunt, cough - productive/paroxysmal
Monitor for oxygen saturation
Auscultation
Listen for absence /equality of breath sounds
Auscultate lung fields for bilateral adventitious noises e.g.: wheeze, crackles etc
To assess bowel sounds, vascular sound; in pregnancy, FHT’s are heard.
.
Palpation
Bilateral symmetry of chest expansion
Skin condition – temperature, turgor and moisture
capillary refill (central/peripheral)
Fremitus (tactile)
Subcutaneous emphysema
Palpation
Bilateral symmetry of chest expansion
Skin condition – temperature, turgor and moisture
capillary refill (central/peripheral)
Fremitus (tactile)
Subcutaneous emphysema
Percussion
To identify organ size and detect fluid, gas or masses.
