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#ADVENTITIOUS BREATH SOUNDS IN INFANT SKIN#

Tremor: may be caused by beta 2 agonist use (e.g.congestive heart failure) and cyanosis may indicate underlying hypoxaemia. Colour: pallor suggests poor peripheral perfusion (e.g.Inspect the hands for clinical signs relevant to the cardiovascular system: The hands can provide lots of clinically relevant information and therefore a focused, structured assessment is essential. Antibiotics: pneumonia, bronchiectasis, cystic fibrosis.Note any medications by the bedside or in the child’s room and consider what underlying diagnoses they may indicate: Tracheostomy: upper airway obstruction – each child in the UK should have a box of emergency tracheostomy equipment (often blue/red in colour).Oxygen saturation monitor or oxygen cylinder: chronic lung disease.Feeding tubes (NG/NJ/gastrostomy): ex-premature infant, cystic fibrosis.Observe for any equipment in the child’s immediate surroundings and consider why this might be relevant to the respiratory system: Chronic stridor: laryngomalacia, subglottic stenosis.Acute stridor: croup, foreign body, bacterial tracheitis, epiglottitis.Hot potato voice: peritonsillar abscess.Productive cough: lower respiratory tract infection.

Cough with wheeze: asthma, viral-induced wheeze.

Note any audible sounds as you observe the child and consider what underlying pathology they may indicate: See the end of this guide for a non-exhaustive list of clinical syndromes which can be associated with respiratory system pathology. Pay attention to features that may indicate the presence of an underlying genetic condition:

Weight: note if the child appears a healthy weight for their age and height.

blood dyscrasia, chronic disease) or poor perfusion (e.g.

#ADVENTITIOUS BREATH SOUNDS IN INFANT SKIN#

Pallor: a pale colour of the skin that can suggest underlying anaemia (e.g.congenital heart disease) or respiratory disease (e.g. Shortness of breath: may indicate underlying cardiovascular (e.g.peripheral vasoconstriction secondary to hypovolaemia) or inadequate oxygenation of the blood (e.g. Cyanosis: bluish discolouration of the skin due to poor circulation (e.g.Activity/alertness: note if the child appears alert and engaged, or quiet and listless.

waiting room, hospital bed) and take note of their appearance and behaviour: Observe the child in their environment (e.g. General inspection Appearance and behaviour You might also be interested in our OSCE Flashcard Collection which contains over 2000 flashcards that cover clinical examination, procedures, communication skills and data interpretation.