Dear All

Thank you for particpating in the session.

In Rapid Random Review we disussed:

• Hypertension
• Joint problems in ‘Healthy’ children
• Acute Mastoiditis

We started the Clinical stations. Clinical stations now have children return to the exam – only development station does not have children and remains ‘virtual’.

 Ag discussed Do’s, Donn’ts and How to covering General examination and some details for CVS. It is important to have a structured approach while examining, you need to have a smooth flowing techniques. Start with General Observation – examination as that is part of every station – even if not mentioned explicitly. 

The Points to remember are:

• Introduce and build rapport with child & parent
• Seek permission with relevant task
• Hand hygiene – confirm has been done
• If Painful – will stop.
• Practice to finish the examination in 5 minutes.
• Start with General obsvervation – 30 secs
• Move to Exposing the relevant part
• Inspection – start with hands then move closer
• Palpation – Percussion – Auscultation
• Ask child to dress up again – when finished
• Think how findings fit into a diagnosis 
• If you cannot – think of Differential diagnosis
• Presentation – with your ‘opinion’ NOT a repeat of what you noted
• Thank the child and parent when leaving the room.
• Wrtie Examination of each system on an A4 sheet 
• Practice with One system per day when in clinic or ward

Please visit www.mrcpchonline.org to add your comments or add points I may have missed.

Anil Garg