PEDIATRIC EXAMINATION TRICKS AND TIPS
How to Assess the Child
1. Establish trust with the patient
2. Have the materials and equipments ready and
accessible before starting the exam
3. Give patient choices
4. Be flexible. Start with the less invasive or less
difficult portions of the exam. Grab the
opportunity if there is any.
5. Always use the tongue depressor in examining
the posterior oropharynx during oral exams.
6. Let the patient examine the instruments first by
letting them briefly hold it or play with it
7. Perform a mock exam on something or someone
else before examining the patient
8. Use the stethoscope to palpate the abdomen
9. Always perform a genital exam in all male
patients presenting with abdominal pain
10. Do a genitourinary (GU) exam on all patients
wearing diapers.
11. If there is a suspected musculoskeletal injury that
the patient may be guarding, consider asking the
patient’s parent/guardian first to push on the
suspicious area before trying it yourself
12. Positioning the patient is the key in taking an ear
exam. Ask for assistance from the parent to hold
the child in their lap, holding the patient’s head
and arms in a bear hug manner.
Rationalization
To make the child feel safe and secure. To establish
rapport since trust foster cooperation
For work organization and efficiency
Children are most likely to refuse to be examined, so
giving them choices encourages them to cooperate.
Starting with invasive portions like the ear exam will
make the patient uncomfortable and already lose their
trust in you.
To depress the tongue to give clear views of the throat
and mouth to check for any lesions.
The child will feel more at ease and more likely to
participate knowing that the instruments being used
are safe.
So the patient can see that the exam or procedure is
safe and harmless
To assess for surface abnormalities, for tenderness,
also for the patient to be comfortable and less anxious
So not to overlook a testicular torsion or hernia since
it’s usually associated with abdominal pain
To make sure there aren’t any unexpected findings
hiding under the diaper
Helps you give an idea of the location of the injury
without you scaring the child.
For stabilization and for ease of work so that the exam
can be done.