Seeing Paediatric Patients in OPD Prof. Pushpa Raj Sharma.
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Transcript of Seeing Paediatric Patients in OPD Prof. Pushpa Raj Sharma.
![Page 1: Seeing Paediatric Patients in OPD Prof. Pushpa Raj Sharma.](https://reader036.fdocuments.net/reader036/viewer/2022082517/56649ebc5503460f94bc479e/html5/thumbnails/1.jpg)
Seeing Paediatric Patients in OPD
Prof. Pushpa Raj Sharma
![Page 2: Seeing Paediatric Patients in OPD Prof. Pushpa Raj Sharma.](https://reader036.fdocuments.net/reader036/viewer/2022082517/56649ebc5503460f94bc479e/html5/thumbnails/2.jpg)
Why it is special?
Common problem: fever (90%) Limited time Large number of patients. Not to miss the serious ones. Not to over prescribe drugs. Parents satisfaction Ethical
![Page 3: Seeing Paediatric Patients in OPD Prof. Pushpa Raj Sharma.](https://reader036.fdocuments.net/reader036/viewer/2022082517/56649ebc5503460f94bc479e/html5/thumbnails/3.jpg)
Serious conditions
Not able to suck, swallow Unconscious, drowsy, lethargic Convulsion in this episode Neonate Chest indrawing Oedema Tachypnoea
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History taking in OPD
Write main presenting complaint Start examining while asking
questions around the presenting complaint
Commonest complaints Fever Loss of appetite Diarrhoea cough
![Page 5: Seeing Paediatric Patients in OPD Prof. Pushpa Raj Sharma.](https://reader036.fdocuments.net/reader036/viewer/2022082517/56649ebc5503460f94bc479e/html5/thumbnails/5.jpg)
Examples of questions for fever For how long? Usually 1-3 days Does he/she coughs? Any diarrhoea: blood in stools Any rash Any body at home/hostel having similar
problem Ear discharge Any convulsion Any swelling or wound Any joint problem
![Page 6: Seeing Paediatric Patients in OPD Prof. Pushpa Raj Sharma.](https://reader036.fdocuments.net/reader036/viewer/2022082517/56649ebc5503460f94bc479e/html5/thumbnails/6.jpg)
Looking a child with fever
Congested eyes Runny nose Congested throat/ulcers/enlarged
tonsils Rash Tachypnoea observation Spleen and liver
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Fever diagnostic appraochToxic look without any localising signs Paracetamol/ if more than 2 days ask for
culture/TLC and DLC Follow up day with reportLocalising signs (red eyes/ runny nose/
congested throat.) Paracetamol Follow-up after 2 daysLocalising signs (liver/spleen_ Enteric/hepatitis/malaria/viral
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Final prescription
Presenting complaint and duration Principle findings: toxic/localizing
signs Paracetamol Antibiotics
Formulations costs
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